Opinions on Compliance Work of Insurance Companies

Compliance management of insurance companies should be considered from three aspects: business, finance and claims settlement

I have summarized the compliance management experience. In addition, the experience introduction materials should be combined with your organization's The situation will be explained in detail. The following content is for your reference only

(1) Business development

(1) Strictly implement the unified legal person system and strictly authorize management;

(2) Strictly implement the terms and rates approved or filed by the insurance regulatory department, and strictly prohibit the mismatching of terms and disguised fee reductions for the purpose of competition; assume corresponding insurance responsibilities in accordance with regulations;

(3) Adhere to strict review procedures and operate in accordance with the approval opinions;

(4) Strictly implement the relevant regulations on off-site, centralized, joint guarantee and independent guarantee business and perform corresponding approval filings formalities.

(5) Strictly implement the pure risk loss rate, and the usage rates are calculated in accordance with the pure risk rate regulations;

(6) The refund work complies with relevant requirements, and illegal refunds are eliminated Or approve premium reductions and refunds in strict accordance with the approval opinions;

(7) Strictly operate insurance-related regulations.

(2) Financial management:

(1) Strictly follow the new accounting standards and premium income recognition principles to truthfully reflect premium income; there is no "small treasury" or "off-the-book" "Account" and other phenomena;

(2) There is no unaccounted item in a non-financial sense or the phenomenon of falsely listing premiums receivable and falsely listing expense costs through unaccounted items;

(3) Strictly manage funds in accordance with the relevant provisions of the "Fund Management Measures"; strictly follow the fund management regulations of "Two Lines of Revenue and Expenditure", and all fund receipts and expenditures are included in the accounting; prevent excessive storage of cash beyond the limit and exceed the scope. Phenomenons such as the use of cash and "white slips to be deposited into the treasury";

(4) Strictly follow financial management regulations and standardize the accrual, use and management of claim expenses; there are no business exhibition fees and administrative office expenses to be listed as claims settlement Expense phenomenon;

(5) All operating costs and expenses shall be reported according to the facts, and the financial data shall be true and accurate;

(6) Various liability reserves shall be made in accordance with laws and regulations; The reserve data is true and accurate;

(7) There are no irregularities such as tearing up and paying bills, Yin and Yang insurance policies, system outgoing orders, and net premiums being recorded.

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(2) There is no intentional fabrication of insurance accidents that have never occurred to make false claims. It is strictly prohibited to intentionally expand the scope of insurance accident losses and falsely increase the amount of compensation; it is prohibited to include expenses unrelated to the compensation case into the compensation case for expenditure. ;

(3) There is no illegal behavior such as colluding with other units to defraud compensation;

(4) Continuously establish and improve claims service standards; on the premise of ensuring the quality of claims, earnestly Implement the work of simplifying claim documents and optimizing claims workflow.

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