Summary of PICC claims settlement work

1. Review of work in XX

At the beginning of XX, the company combined the various business goals issued by the municipal branch and established the company's "understand the situation, unify thinking, accelerate development, The overall idea of ??"achieving goals" has clarified the focus of the work throughout the year, and adopted powerful measures of "five-pronged approach and multi-faceted approach" to achieve "a good start", "double over half" and business development goals in each stage, in order to successfully complete Lay a solid foundation for the whole year’s work tasks

1. Improve and strengthen the main insurance. Focusing on "consolidating non-commercial vehicles, competing for household vehicles, competing for commercial vehicles, exploring agricultural vehicles, and expanding motorcycles", we will actively respond to market changes and strive to achieve effective growth in the auto insurance business. First, we have strengthened the cooperative relationship with major customers such as automobile transportation companies, automobile trading companies, Hongyun Company, Fengda Logistics, Fukang Logistics, etc., provided supporting services, and ensured the insurance of operating vehicles. Through public relations, we competed for the insurance business of some cars in other companies and won more than 95% of the vehicles in the county to be insured by our company; secondly, we did a good job in the centralized bidding and procurement of government official car insurance to ensure that our company exclusively underwrites the insurance business. For this business, we have strengthened the renewal, expansion and intermediary agency business of government procurement business, and firmly controlled the limited insurance resources in our own hands; thirdly, we have closely cooperated with the traffic police brigade and the Agricultural Machinery Bureau, and strived to do a good job in various types of business. The underwriting of agricultural vehicles and motorcycles has achieved good results by carrying out special insurance services such as toll collection on the road and locking motorcycle dealers to collect door-to-door collections. It has quickly reversed the low insurance rate of motorcycles and agricultural vehicles in Lichuan in recent years. The passive situation of stagnant premium income has led to a substantial increase in the business, making motorcycle insurance a new growth point for our company's business development in XX; fourth, we must firmly seize the opportunity to continue to release the effects after the implementation of compulsory traffic insurance and vigorously develop Personal agency marketing expands the insurance business of sporadic vehicles and private cars, making it a new highlight in the development of auto insurance. Fifth, in view of the shortage of local vehicles and insufficient insurance sources, we actively expanded the overseas auto insurance business and signed a premium of 400,000 yuan.

2. Seize development opportunities and maintain rapid and healthy development of non-auto insurance business. Grasp the big ones and promote the small ones, so as to embrace the "watermelon" without losing the "sesame seeds", extend the industry's tentacles to profitable enterprises and insurance blank spots, and do a good job in underwriting small and bulk business with resilience and endurance.

Property insurance business: First, combining the characteristics of Lichuan’s large number of underwriting companies, wide coverage, and low single premiums, we will strengthen the research on property insurance in key units and ensure that several power supply limited liability companies and Global Porcelain Factory have good returns. , People's Hospital, Huayu Bamboo Co., Ltd., Jiangxi Muyuan Industrial Company and other units renewed their insurance as scheduled, with premiums collected of more than 200,000 yuan; secondly, they strengthened contact and cooperation with relevant government functional departments and park offices, and integrated internal and external resources , linking up and down, conducting three-dimensional public relations, deeply exploring the property insurance business of industrial park enterprises, ensuring that park enterprises such as Shangfeng Plastic Co., Ltd. and Xinyue Fashion Factory are insured, and finally collecting a premium of 65,000 yuan, which has become the key to the development of our company's non-auto insurance business A new growth point; third, we have done a good job in underwriting the policy-capable reproductive sows. We have insured 2,600 reproductive sows for a total of 160,000 yuan in premiums, ranking third in the city in terms of underwriting number, and ranking fourth in the city in coverage.

Accident insurance business: Focus on group insurance with one hand and small individual business with the other, focusing on the marketing of major insurance types such as group accident insurance, card insurance, and school insurance. The first is to promote and expand the group casualty insurance business of key units, and has successively underwritten group casualty insurance and additional medical insurance for the Tobacco Marketing Center, Power Supply Co., Ltd., Global Porcelain Factory, Telecommunications Bureau, Meijia Ceramics Company, and private enterprises seeking investment, with a net income of The premium is 100,000 yuan; the second is to focus on direct sales, expand marketing, and strive to promote the development of card-type personal insurance. The card-type casualty insurance business signed by marketers alone amounted to 30,000 yuan throughout the year; the third is to overcome the influence of external factors such as administrative intervention in school and child insurance , adopted the method of direct sales plus personal agency marketing, stabilized the downward trend, and collected premiums of 212,000 yuan. In addition, we actively promoted the "Jinwa" investment and protection-type accident insurance, with sales of 315,000 yuan, completing 105 of the tasks assigned by the municipal branch.

Strictly follow the requirements of the "Three Centers", standardize business operation procedures, eliminate claims beyond authority and false claims, and enhance the company's core competitiveness.

5. Innovate management methods. Over the past year, Lichuan Branch has unswervingly adhered to the policy of "safety first, prevention first", focused on the construction of internal control systems, and paid close attention to the implementation of the system.

First, strict budget management, strict financial disciplines, improve payment procedures, curb the growth of operating expenses and indirect claims and investigation costs, and strictly prohibit the listing of unreasonable indirect claims expenses and the use of abnormal approval and refund means to obtain arbitrage. Expenses, put an end to any form of flexibility and hidden accounts, strictly follow business specifications and financial systems, and prevent various risks.

Second, tighten the focus on safe operations, fully implement the "three preventions and one guarantee" responsibility system for comprehensive management, and intensify inspection and supervision. Conduct comprehensive self-examinations every quarter on the safety of office buildings, dormitories, and canteens, as well as fire prevention, theft prevention, and virus prevention in important areas. In view of the poor condition of the vehicles, tight funds, and frequent driving of the unit, a special inspection and education was conducted for the drivers, requiring them to strictly implement the "Five Don'ts": no driving under the influence of alcohol, no hero cars, and no driving. Fatigue cars are not allowed to drive with a breakdown, and driving at night is not allowed unless there are special circumstances. At the same time, all employees of the company have been trained and publicized on fire protection knowledge, which has improved safety awareness and established the idea of ????always working hard and always sounding the alarm.

Third, in view of the characteristics of the industry, a number of rectification activities such as the construction of party style and clean government, honest service education, anti-money laundering education, and special work on commercial bribery have been carried out to standardize employee behavior and operate in accordance with laws and regulations; actively Launch the first Customer Festival event of "Join Hands with PICC Property and Casualty Insurance, Enjoy Gold Medal Service", focus on service resource advantages, strengthen Olympic brand promotion, deepen gold medal service projects, highlight corporate image, and then achieve to enhance customer value, improve customer experience, highlight the company brand, Promote business development.

Fourth, actively carry out flood and disaster prevention work. In view of the characteristics of floods, mudslides, landslides and other disasters that are prone to occur during the flood season, a disaster prevention and loss prevention work meeting was held, a disaster prevention and loss prevention working group was established, and multi-pronged disaster prevention measures were adopted to address both the symptoms and root causes: First, strengthen In order to communicate and contact with the County Meteorological Bureau, Security Inspection Bureau and Flood Control Headquarters, we will make every effort to prevent losses and reduce disasters, try to reduce the occurrence of insurance accidents, and prevent disasters before they happen; secondly, we must fully understand the company's business situation that is prone to flood disasters and be aware of them. Timely reminders are provided to insured persons with premiums exceeding RMB 10,000 and insured amounts exceeding RMB 1 million to help policyholders do preventive work; thirdly, pay close attention to the flood prevention and control situation of customers, and conduct a thorough investigation of customers' flood prevention and resistance capabilities, house by house. We will visit and focus on policyholders who have experienced disasters in previous years, and send dedicated personnel to help policyholders do disaster prevention and loss prevention. We have sent personnel to the school many times to instruct teachers and students on how to eliminate safety hazards, how to escape and save themselves in emergencies, how to stay away from low-lying areas when a storm comes, and how to avoid going out in the countryside on rainy days, etc. to ensure nothing goes wrong.

Fifth, we must do a good job in building the workforce and consolidate the business foundation. First, we must adhere to business management with one hand and team stability with the other, combine strong ideological work construction with effective incentive mechanisms, and educate employees Correctly understand the company's business direction, difficulties and challenges it faces, objectively analyze the competitive environment, and create a good atmosphere within the company that is forge ahead and united; second, combine the head office's "Employee Code of Conduct" and "Customer Standardized Services", etc. Learn the principles and continuously improve the service quality and service level of employees.

Sixth, breakthrough progress has been made in the construction of rural marketing outlets. In the first half of the year, rural marketing offices were set up in three towns: Desheng, Hongcun and Sheping, which took a solid step towards comprehensively advancing the property insurance business into the rural area. In mid-December, centralized training was conducted for new marketers joining the company. The training content covered practical operations of insurance bases, business development skills, business behavior, laws and regulations, etc. The training was very successful and achieved the expected results.

In the past year, although our company has achieved certain results in various tasks, there are still some shortcomings, mainly in the following aspects:

1. Various types of insurance Unbalanced business development among them. The development of corporate property insurance and home property insurance businesses was slow, the personal casualty insurance business declined slightly, and the motorcycle and agricultural vehicle business failed to fundamentally improve.

2. The low insurance participation rate in industrial parks has not been effectively improved.

3. Premiums receivable are still at a relatively high level.

The above shortcomings need to be overcome and improved in future work.

2. Work measures in XX

In XX, the business situation we face will be more severe: the number of entities in the property and casualty insurance market will further increase, competition in the industry will become increasingly fierce, and business development will be affected; The reduction of compulsory traffic insurance premium rates and the increase of insurance coverage will inevitably have a series of impacts on the company's business operations; the country implements "tight monetary policy" and bank lending will further shrink, thus affecting the development of the insurance business. However, difficulties and opportunities coexist, and challenges and hopes coexist. Our company will focus on efficiency goals, actively face the market, scientifically formulate various work measures suitable for its own actual conditions and pay close attention to their implementation, and strive to achieve various business goals and business, A virtuous cycle of resources and benefits continuously improves the company's development capabilities, innovation capabilities, management and control capabilities, and execution capabilities.

(1) Seize market opportunities and accelerate the pace of business development.

1. Integrate resources to maintain the growth momentum of auto insurance

In the new year, the company will comprehensively integrate the entire auto insurance development, management and services to achieve "sales-underwriting-claims-finance" "Effective connection of the service chain and actively respond to market changes. The first is to continue to strengthen the cooperative relationship with major customers such as automobile transportation companies, automobile trading companies, Hongyun Company, Fengda Logistics, etc., pay close attention to the insurance of business vehicles, and strive to ensure that 90% of the vehicles come to our company for insurance; the second is to do a good job with the government We have centralized bidding and procurement for official vehicle insurance and actively strived for government support, with our company exclusively underwriting this business; third, we used the construction of rural marketing outlets as an entry point to deeply tap the market potential of tractors and motorcycles; fourth, we vigorously developed individual Through agency marketing, we will expand the business of sporadic vehicles and family cars, making them a new highlight in the development of auto insurance.

2. Optimize the structure and expand into new non-auto insurance areas

Continue to focus on three lines: stabilizing continuing business, striving to compete for business back, and expanding new business. First, dig deep into the property and employer liability insurance business of industrial parks. We will strengthen contact and cooperation with relevant government functional departments and park offices, integrate internal and external resources, link up and down, conduct three-dimensional public relations, and strive to attract more park enterprises to insure, making it a new growth point for the development of our non-auto insurance business. Secondly, continue to work closely with departments such as safety supervision, transportation management, urban construction, health, and education committees to provide non-coal mine employers’ liability insurance, passenger carrier liability insurance, construction liability insurance, medical liability insurance, and road carrier insurance. The underwriting work of liability insurance and motor vehicle third party liability insurance business is stable, and efforts are made to expand campus liability insurance, ensure that campus liability insurance premium income increases year by year, and steadily promote the long-term and effective development of campus liability in our county; at the same time, actively promote Tourism liability insurance, fire public liability insurance, and forest fire insurance promote the optimization of business structure. Third, seize the opportunity to strengthen communication and contact with relevant government departments, strive for government support and policy support, promote the long-term development of reproductive sow insurance, and launch some farm fire insurance, flue-cured tobacco insurance and other businesses in a timely manner. Fourth, focus on the marketing of major insurance types such as group accident insurance, student accident insurance, and decentralized card accident insurance; focus on the supporting sales of driving accident insurance and auto insurance businesses; and strive to promote other types of accidental injuries suitable for sales at rural outlets. Insurance; the company launched a number of separate insurance campaigns to achieve steady growth in the accident insurance business.

(2) Pay close attention to the construction of marketing channels and improve market penetration capabilities.

First, speed up the construction of rural marketing channels.

Strengthen the investigation and research of the rural market, develop various rural insurance products with market selling points according to local conditions, promote the company's marketing channels to develop deeper and wider, meet the growing insurance needs of rural people, and fully expand the company's business development space . The second is to promote the rapid development of intermediary agency business. Increase cooperation with commercial banks, credit unions, postal services, urban construction, traffic police, transportation management, professional fleets and other part-time agents, and use their functions and powers to increase agency insurance types and expand agency business; at the same time, proactively and extensively contact some Insurance brokers and professional insurance agents should carry out effective cooperation in a timely manner. The third is to continue to implement the personal agency marketing system, strengthen marketing business management and training, increase the per capita production capacity of marketers, strive to cultivate a property insurance personal agency marketing team with high comprehensive quality that meets the needs of market development, and give full play to the familiarity and familiarity of marketers. With the advantage of flexible business development methods, we can deeply tap the potential of decentralized businesses such as property insurance, personal injury insurance, liability insurance, and individual industrial and commercial insurance to form new business growth points as soon as possible.

(3) Innovate business methods and improve service levels.

First, create honest and harmonious insurance. Combining the characteristics of the company's business development and the ideological reality of employees, we carry out various forms of integrity education, standardized service education, professional ethics education and other activities, so as to significantly improve employees' political quality, professional ethics level and standardized service level, and solidly promote the control of commercial bribery, etc. Special work, correct business behavior, and create a good brand image of PICC Property and Casualty; carry out in-depth corporate culture construction, strive to build a harmonious enterprise, enhance the company's cohesion and centripetal force, and create a good atmosphere within the company of determination and integrity. The second is to build a high-end service brand, improve the responsiveness and service level of large-scale commercial insurance professional teams such as professional fleets, increase continuous tracking of large industries and large policyholders, provide differentiated insurance services, and make full use of SMS, 95518 and other platforms , timely convey our company's new products, new services, and new activity information to improve the brand image of PICC services. The third is to provide claims settlement services conscientiously. Further efforts will be made to provide fast service and customer convenience, especially for insurance accidents that are highly concerned by government departments such as compulsory traffic insurance, carrier liability insurance, non-coal mine liability insurance, reproductive sow insurance, etc., and provide effective claim settlement services to allow government departments and customers to Satisfied; Seriously accept social supervision, publicly commit to 24-hour service, on-site inspection, case closing, and limited-time service for collecting compensation, so that customers can truly realize that PICC Property & Casualty Insurance is "worrying about customers' needs and thinking about customers' thoughts", and establishing PICC Property & Casualty Insurance's satisfaction and peace of mind Claims image. Fourth, in accordance with the requirements of workplace construction, we must conscientiously implement workplace standards, product promotion specifications, service etiquette specifications, and service standards specifications to promote the company's service quality and service level to a new level.

(4) Strengthen internal management and promote company development.

First, improve the internal control system and strictly control and prevent operating risks. In accordance with the requirements of various rules, regulations and laws, we standardize underwriting, claims settlement and financial operations, operate in compliance with laws and regulations, and form a situation where we act in accordance with the rules and manage people by the system. The second is to do a good job in the control and clean-up of premiums receivable, strictly implement the principle of "whoever takes the insurance, who advances the funds, and who collects the collection". By strengthening the management of issuing orders and invoices, we implement source control of premiums receivable and resolutely block operations. Loopholes in management. The third is to properly control claims, loss assessment and compensation verification, reduce business quality errors, give full play to the role of medical consultants, squeeze out the water in compensation, control the average compensation per case, and ensure that the compensation rate does not exceed 60%. In order to effectively improve the quality of claims settlement, the auto insurance loss assessment review system is improved to eliminate all unreasonable items and expenses; the medical tracking system is improved, and in principle, medical tracking is carried out for inpatient treatment and large accident outpatient cases; the medical expense review system is improved and all involved Compensation cases for medical expenses must undergo strict review before entering the settlement process; improve the investigation system for difficult cases, strengthen cooperation with the procuratorate, give full play to the role of the claims appraisal center, increase anti-counterfeiting and fraud prevention efforts, and eliminate false claims occur. The fourth is to strictly control expenses and costs to improve the company's profitability.

Scientifically and accurately measure operating results, increase revenue and reduce expenditure, use limited funds wisely, further standardize the channels for expenditures, truly reflect the cost structure, ensure the rationality and compliance of expenditures, and make financial information It can provide applicable and reliable data support for the company's decision-making to ensure the realization of annual operating benefits.