Chinanews.com, January 20th. The China Banking and Insurance Regulatory Commission today issued on its official website the "Notice of the Personal Insurance Department of China Banking and Insurance Regulatory Commission on Printing and Distributing the "Negative List" of Life Insurance Products (2021 Edition)". The notice stated that companies should carefully compare the new version of the "Negative List" "Checklist", sort out and self-examine the insurance products on sale, and rectify existing problems in a timely manner.
At the same time, in daily product development and management work, companies should strictly comply with regulatory requirements, "negative lists" and other regulatory requirements, conscientiously manage the entire process of product development, sales, and backtracking, and earnestly assume the main responsibility of product management, and continuously improve Operation and management capabilities.
In the next step, the Life Insurance Department of the China Banking and Insurance Regulatory Commission will continue to strictly supervise products, give full play to the long-term effects of product notifications, "negative lists" and other mechanisms, regularly carry out product supervision "look back", and check the number of notifications and repeated problems. The company has adopted a series of regulatory measures, including regulatory interviews, regulatory accountability, and public disclosure of the results of the treatment, to continuously regulate the company’s product development and management behavior.
"Negative List" of Life Insurance Products
(2021 version)
1. Product terms and conditions
(1) The clauses are lengthy, not prominent, not popular, not easy to understand, and not easy for consumers to read and understand.
(2) The provisions for exempting the insurer from liability and obligation are not unified and centralized, and some agreements lack legal basis and judgment standards and lack reasonableness.
(3) The clauses are not rigorous in describing the insurer’s obligations to the policyholder, the insured and the beneficiaries, and there is a potential risk of misleading sales.
(4) Some optional rights of the policyholder, the insured and the beneficiaries are not clearly stated in the clauses, such as the right to reduce insurance, the right to renew, etc., which may infringe the interests of consumers.
(5) There are unreasonable agreements in the clauses that restrict consumers' legal rights.
(6) The provision of unreasonable clause expressions in the clauses facilitates misleading sales.
(7) The insurance amount stipulated in the clause is not standardized, which is inconsistent with the concept of insurance amount stipulated in the Insurance Law.
(8) The stipulations on the statute of limitations in the clauses are inconsistent with the provisions of the Insurance Law.
(9) The agreement on the refund of the cash value of the insurance policy in the clause is inconsistent with the provisions of the "Judicial Interpretation III of the Insurance Law".
(10) The scope of the court with jurisdiction agreed in the clause is inconsistent with the provisions of the Civil Procedure Law on regional jurisdiction.
(11) The scope of "social medical insurance" agreed in the clause is inconsistent with the provisions of the "Social Insurance Law".
(12) The requirements for claims settlement materials in the clause are unreasonable.
For example, some product clauses stipulate that the insurance application requires a valid survival certificate, but does not explain the specific form of the valid survival certificate; the accident insurance product clause stipulates that the insurance application shall not only provide the accident confirmation letter issued by the traffic control department, It is also necessary to provide unreasonable materials such as the current transportation ticket (stub); the life insurance product clause stipulates that the death insurance application shall provide not only the death certificate and the certificate of household registration cancellation, but also the cremation certificate, the funeral certificate and other unreasonable materials.
(13) The expression of the beneficiary in the clause is not standardized.
For example, in some product terms, the beneficiary states that the first beneficiary is the loan issuing institution unless otherwise agreed.
(14) The waiting period, guarantee liability or liability exemption stipulated in the terms of health insurance products are unreasonable.
For example, some product terms stipulate that the symptoms or signs that occur during the waiting period will be used as the basis for exemption in the event of an insured accident after the waiting period, and there is no objective judgment standard for the symptoms and signs, which infringes on the interests of consumers.
(15) The clauses are unreasonable and the insurance payment conditions are increased in disguise.
For example, the terms of term life insurance and whole life insurance products stipulate that after the death of the insured, the death insurance benefit will not be paid in full, and the survival benefit must be paid in installments to the policy beneficiary according to the stipulated standard in the clause; the terms of the disease insurance product stipulate that the insurance is insured After a person is diagnosed with the insured disease, he needs to survive for a certain period of time before he can receive insurance payments.
(16) At the end of the insurance period/guarantee renewal period stipulated in the terms of the medical insurance product, if the company does not receive a non-renewal application, it will be deemed to be renewed, which infringes the consumer's right to choose.
(17) The terms are inconsistent, and the guarantee content demonstrated by the case in the reading guide is inconsistent with the actual terms and conditions, and there is a potential risk of misleading sales.
(18) The terms of short-term health insurance products contain the statement that the product rate may be adjusted during renewal.
(19) It is stipulated in the terms of health insurance products that consumers shall not individually cancel the additional insurance, or stipulate that the insurance payment of the product is based on whether the insurance payment of other products is the precondition, which is suspected of infringing on the interests of consumers.
(20) Individual companies use "insurance + trust" and other non-insurance financial products as selling points to advertise, confuse insurance products with other financial products such as trusts, bank wealth management, and funds, and confuse the concept of insurance products.
(21) The setting of exemption clauses may unreasonably exempt or reduce the liability of the insurer.
For example, the clauses of nursing insurance products stipulate exemption from liability for insurance incidents caused by bacterial or viral infections. This agreement does not conform to common sense and violates the interests of consumers.
2. Product responsibility design
(22) The product design is similar, and some of the submitted products are seriously homogenized.
(23) The design of participating insurance products is alienated. The terms of the product include concepts such as account management and guaranteed interest rates, which are similar to universal products.
(Twenty-four) The design of nursing insurance products is alienated, and the product design is universal, and the insurance premium of nursing liability risk accounts for a relatively low proportion of the overall premium, which is out of the source of risk protection.
(25) The design of medical insurance products is alienated, and the risk-free coverage or the insurance amount is lower than the premium, which seriously deviates from the attributes of insurance protection. At the same time, it also provides insurance fund investment value-added services.
(26) The design of annuity insurance products is alienated. At the end of the first year, the cash value exceeds the premiums paid. At the same time, the terms are designed with flexible functions of increasing and decreasing the amount of insurance, so that the universal insurance can freely receive part of the account without any charge. cost.
(27) The protection function of insurance products has weakened. Nursing care insurance products only cover care responsibilities caused by accidents; annuity insurance products have neither protection nor savings functions.
(28) The product liability design is inconsistent with the product definition. Term life insurance products include optional liability for accidental disability or end-of-life insurance premium payment in advance; sickness insurance products include survival benefit payment liability; nursing care insurance products include general death liability ; Medical insurance products only bear the responsibility for medical services.
(Twenty-nine) Critical illness insurance products adjusted the additional expense rate coefficient backwards to adjust the annual payment rates of individual products with different payment periods to a consistent level, which has the potential to mislead sales.
(30) The hesitation period of health insurance products is too short; the waiting period is too long.
(Thirty-one) The additional insurance products take into account the incidence of major insurances and critical illnesses in the calculation of the rates and current prices, but do not restrict the ratio between the main insurance and the supplementary insurance. There may be insurance products alienated into wealth management products during combined sales. The hidden dangers.
(32) The universal account of universal insurance products is settled on a daily basis. The settlement method is unreasonable and there is a risk of gimmick marketing.
(Thirty-three) The liability agreement for disease insurance products can adjust the rate level based on the results of genetic testing by designated institutions, which does not meet the requirements of the "Health Insurance Management Measures".
(Thirty-four) Investment-linked insurance products agree that withdrawing during the hesitation period is the return of the policy account value, and it does not distinguish whether the insured chooses to transfer insurance premiums to the investment account during the hesitation period.
(Thirty-five) The insurance policy loan ratio is not clearly agreed, and there is no agreement not to exceed 80% of the cash value.
(36) Insurance products disguisedly extend the waiting period by adjusting the amount of insurance, or by incomplete refund of insurance premiums that occur during the waiting period for risk accidents, which punish consumers in disguised form and harm their interests.
(37) The product liability design is unreasonable, and sickness insurance products take the occurrence of acute illness and death as the condition of payment; the insurance liability of annuity insurance products only has the option of annuity, or requires the insured to apply for payment.
3. Product rate determination and actuarial assumptions
(38) Expense-compensation medical insurance products, in order to pursue marketing gimmicks, blindly set high payment limits in the absence of empirical data and pricing basis, and introduce "lifetime payment limits" in short-term health insurance. Long-term insurance concepts such as “continuous insurance” exaggerate product functions and disrupt market order.
(39) The predetermined additional expense rate or initial expense of insurance products is zero or significantly deviates from the actual expense level, and the product rate is untrue and unreasonable.
(40) Through the adjustment of actuarial assumptions such as cash value calculation, surrender rate, expense rate and other actuarial assumptions, the product form is alienated, and the product supervision regulations are broken in disguise.
(41) Medical insurance products account for an excessively high proportion of health management service fees for all or part of the age group.
(42) The payment period for long-term insurance products is designed to be 2 years, and there is a risk of payment during holidays.
(43) The pricing of cost-compensated medical insurance products does not distinguish between social insurance and non-social insurance.
(Forty-four) Long-term insurance product profit test investment yield assumptions are seriously deviating from the company's investment capabilities and market interest rate trends.
(45) The insurance product insurance period is inconsistent with the expected duration reflected in the surrender rate assumptions in the profit test.
For example, the company considers it to be a non-medium and short duration product, but the surrender rate of the profit test assumes that it has exceeded 60% in the first 5 years.
(46) The determination of insurance product rates does not take into account the waiting period.
(47) The accrual method of the unreported claim reserve in the actuarial report does not meet the requirements of actuarial regulations.
(48) The profit test only selects a single model point, without considering the impact of assumptions related to the business structure.
(49) For insurance products with an insurance period of more than one year to determine the cash value of the policy according to other reasonable calculation basis and methods, the actuarial report does not clearly reflect that the calculated cash value is not less than the policy year required by the actuarial regulations The lowest cash value at the end.
(50) For insurance products with an insurance period of one year or less, the minimum cash value of the policy in the policy year is lower than the unpaid net premium.
(51) For health insurance products with guaranteed renewal clauses, the product actuarial report did not state the pricing treatment method for guaranteed renewal and the calculation method of liability reserve.
(52) For long-term insurance products priced at natural premiums, the calculation method of the non-equalized premium liability reserve is not stated in the product actuarial report.
(53) By setting unreasonable assumptions and using profit test factors with a large degree of deviation, the profit test new business value rate is not negative.
(54) Universal products fail to conduct account management and determine the settlement interest rate in accordance with regulations, and the actual settlement interest rate has nothing to do with the account investment situation.
(Fifty-five) The types and definitions of diseases are adjusted in the parameter adjustment management measures for critical illness insurance products.
(56) By deliberately adjusting the investment arrangement of investment-linked products, the product investment rate of return is fixed for a certain period of time, and the product is explicitly or implied as a "guaranteed return" during sales promotion, misleading consumers and linking with investment The risk of investment in type products is borne by consumers themselves.
(57) The dividend ratio between shareholders and consumers used in the dividend demonstration of dividend-sharing products is higher than the dividend ratio given to consumers in the company's actual dividends, which exaggerates the dividend benefits and misleads consumers.
(58) Universal product terms stipulate that only one-off payment is allowed, and consumers are not allowed to add premiums, which is contrary to the flexible payment characteristics of universal products.
4. Product submission management
(59) There are problems such as underreporting, underreporting, and lack of material related information in product filing materials.
For example: the actual submitted materials are less than the materials contained in the checklist; the signatures or stamps of some of the materials are missing; the changed record product does not fully report all the recordable materials involved in the change item; no product code information in the checklist or clause, etc. .
(60) Approval products shall be submitted as record products.
(61) The rate reform information table did not provide core solvency data, or failed to update the company's investment income data in the past five years according to the time of product submission.
(62) The dimension of the rate distinction or the age range covered in the rate table is inconsistent with the description in the product terms and actuarial report.
(Sixty-three) Some products submit product filing materials through the electronic official document transmission system.
(64) Some materials submitted by some insurance products do not belong to the category of product filing materials.
(65) The product information submitted by the product filing system is incorrect, such as: the product name in the submitted information is inconsistent with the terms, and the date of submission is inconsistent with the date of system upload.
(Sixty-six) the actuarial report or other filing materials cited the abolished documents.
(Sixty-seven) Some companies did not strictly follow the relevant requirements of the "Management Measures for Insurance Clauses and Insurance Rates of Life Insurance Companies" (revised in 2015), appointing non-qualified personnel as the company's legally responsible persons; the legally responsible persons left their posts without reporting.
(68) Filing of investment-linked products, failure to report on investment account establishment and other matters in accordance with regulations.
(Sixty-nine) A certain product material was added to other materials and was not separately presented as required.
(70) For the products that have been changed and filed, the old products before the change have not been stopped, or the newly developed products of some companies still use the product names that have been discontinued.
(71) For products that have been filed for one year but the number of insurance policies and premiums are not up to standard, they fail to submit a stop-use report according to the regulations, or resell them immediately after they stop using them.
(72) Inadequate cleaning up of “zombie” products with low quality efficiency, low market recognition and effectiveness, and lack of determination to clean up stock products.
(73) Disguised sales of discontinued insurance products through business extensions and other means.