监管风暴下 财险罚单大

银保监会2021年对保险行业处罚力度空前 罚单总金额近3亿元 财险占比超64%

  保险与每个人的生活息息相关。随着保险行业的竞争日趋激烈,居民在买保险过程中面临的“坑”也不少。刚刚过去的2021年,保险行业更是遭遇了“最严监管”。全球知名会计师事务所普华永道近日发布的《2021年度保险行业监管处罚分析》数据显示,2021年度银保监会及其派出机构共开出2020张保险业监管罚单,共涉及299家保险机构,罚单总金额约为2.8亿元。其中“编制或者提供虚假的报告、报表、文件、资料”是保险机构遭到处罚的首要原因。

  这一分析报告连日来在社会上引起热议,该报告的负责人是普华永道中国金融行业风控及合规服务主管合伙人、注册会计师杨丰禹。在数字化时代,买保险时都存在哪些“坑”?消费者在买保险时要如何“避坑”?针对这些问题,记者近日采访了杨丰禹及部分保险行业资深人士。

  文、图/广州日报全媒体记者 肖欢欢(除署名外)

  购买十年封闭期保险理财产品

  重病时“救命钱”却无法赎回

  今年66岁的陈姨因为两年前的一场大病,看起来格外憔悴。2014年,58岁的陈姨到保险公司购买意外保险时,业务员小莉向她推荐了一款高回报分红险理财产品。这款理财产品有10年封闭期,封闭期内不能拿回本金和利息,否则就算违约,本金会被扣掉50%。

  按照小莉的推演,陈姨手上的120万元现金在购买该款保险理财产品10年后可以拿到240万元,相当于每个月有1万元的理财收益。当时陈姨已经退休3年,手上的120万元几乎是她的全部积蓄。在此之前,小莉曾经帮陈姨购买过几款保险理财产品,回报基本上都在5%以上。“当时她告诉我,这款理财产品是由一家国企做信托背书,理财收益绝对有保障。并且当我面临重大疾病等紧急情况时,可以零成本赎回。为此,我还用手机录了音。”

  Since 2014, Aunt Chen has made a one-time deposit of 120,000 yuan a year to purchase this financial product.

But in the second half of 2020, an accident suddenly happened. Aunt Chen suffered a cerebral infarction while watering the flowers in front of the door. Although she saved her life after rescue, after being discharged from the hospital, Aunt Chen began to have inflexible limb movements and sluggishness on one side. Occasionally Aphasia occurs.

  In September 2020, Aunt Chen, accompanied by her daughter, found an insurance company, hoping to redeem the funds of 840,000 yuan of insurance wealth management products that had been paid for 7 years.

At this time, the salesperson Xiaoli had already left.

The insurance company told Aunt Chen that this wealth management product is still in a closed period and will not expire until June 2024.

Aunt Chen took out the mobile phone recording and indicated that she had agreed with Xiaoli at that time that suffering from a serious illness was an emergency and could be redeemed in advance at zero cost.

Although Xiaoli was willing to testify for Aunt Chen, the insurance company did not recognize this agreement, believing that the phone recording had no legal effect. If Aunt Chen redeemed the funds during the closed period, only 50% of the paid funds could be redeemed; Chen My aunt asked the insurance company what the return of the wealth management product was at this time. The answer was that as of September 2020, the annual income of the wealth management product was 3.2%. What the insurance company said before was only an estimate of the highest return.

  In desperation, Aunt Chen took the insurance company to court and demanded that 840,000 yuan be recovered.

But because Aunt Chen's funds are still in the closed period, they cannot be redeemed.

"Not only can I not get my money back, but even if I borrow money every year, I have to continue to deposit 120,000 yuan. I am really stuck with this insurance and wealth management product."

  "This phenomenon of exaggerating returns but avoiding product risks is very common in some small insurance companies." Wang Chunmei, a senior person in the insurance industry, senior business manager of property insurance of an insurance company, and financial planner, told reporters.

  "When insurance agents show income, they will choose a rate of return of more than 5% to demonstrate, and at the same time help consumers bind a universal account, and use the compound interest of the universal account to drive up the calculation income, so that consumers feel that their money is like Like a snowball, more and more. Like Aunt Chen's '1.2 million yuan will become 2.4 million yuan in 10 years', it can only be realized when the income is maximized. Even if the 10-year closed period ends, the income may not be as good as the bank set. live."

  The total amount of insurance fines for the whole year is nearly 300 million yuan, and property insurance has become a "hardest hit area"

  In Yang Fengyu's view, the phenomenon of exaggerating returns and avoiding risks, like Aunt Chen, is one of the stubborn diseases of the insurance industry that the China Banking and Insurance Regulatory Commission will focus on rectifying since 2021.

  杨丰禹对2021年保险业被处罚原因进行了总结。他表示,“编制或者提供虚假的报告、报表、文件、资料”是保险机构受罚的首要原因,也是“旧疾”;同属行业痼疾的还有“虚构中介业务套取费用”“给予投保人保险合同约定以外利益”和“未严格执行经批准或者备案的保险条款、保险费率”等,其处罚力度、强度都有明显的提升。

  2021年银保监对保险行业的处罚力度堪称“监管风暴”。根据银保监会公开披露数据显示,2021年保险业罚单数量较2020年同比增长22.7%;罚单总金额约为2.8亿元,较2020年同比增长25%,其中财险公司占了大头,被罚没金额达1.5亿元(不含个人处罚),占比超64%。同时,险企中单笔被罚金额最高的也是财产险公司。

  杨丰禹表示,从2021年的监管处罚可以看出,当前的监管将费用真实性、消费者保护作为重中之重,使保险企业违规成本越来越高。

  根据杨丰禹和团队发布的《2021年度保险行业监管处罚分析》,财产险公司被罚没金额占保费比例大大高于人身险公司,这也表明财产险公司合规经营理念还有很大的提升空间。

  为何财险会成为受处罚的“重灾区”?杨丰禹分析,财产险与人身险相比,从产品结构、运营方式、产品多样性都有很大差别。人身险的运营和管理相对财产险来说是比较规范的。但现在各大保险公司推出的财产险门类繁多,出去旅游有保险,住酒店也会有保险,有些金额还很小,从经营的规范程度来说,对它的监管本身就比较困难。而且这些年互联网金融尤其是保险领域,其高速发展与竞争无序导致市场竞争的不规范、不公平,对消费者权益造成很大损害,实际上也增大了市场运营成本,这些成本最终也会转嫁到消费者头上。

  王春梅介绍,财产险包括财产损失保险、责任保险、信用保证保险等,其中光是财产损失险就有上百个门类。而财产险中公众了解最多的就是车险和家庭财产险。

  王春梅表示,家财险的设计很像百万医疗险,一般是损失多少补偿多少。在理赔中,保险公司有专门的定损人员,经过定损流程,评估房屋修复所需要的金额。而在房屋定损方面,保险购买者本身是没有话事权的,房屋最终评估价值多少,完全由保险公司说了算。尽管可以对定损结果提出异议,但基本上都无法改变定损结果。“据我所知,财产险的房屋保险,不管买的保险金额多少,最多都是100万元封顶。”

  王春梅表示,家财险在过去5年有升温的趋势,尤其是近年来国内频发的暴雨、洪涝灾害、地震灾害等,让家财险的关注度较此前有所提高,但总体上渗透率并不高。数据显示,截至2020年末,我国家财险保费规模为90.79亿元,占我国财险业整体保费规模尚不足1%。

  “退保理财”套路:“业务员”诱导消费者退保购买“高收益”产品

  对于杨丰禹对财产险的分析,王春梅也表示认同。“财产险公司受处罚多也是意料之中,因为财产险种类太多、太庞杂。而财产险套路多,尤其是各类保险理财产品。”她说,一些互联网保险营销广告界面设置不规范、不清晰,在页面中诱导消费者勾选“领取保障”“自动续费”等选项;还有平台以默认勾选、强制勾选等方式进行捆绑搭售,强制要求消费者购买非必要的保险产品或服务,让人防不胜防。

  王春梅介绍,在五花八门的保险理财产品中,最常见的套路就是“退保理财”。

  去年8月,一名自称保险公司业务员的人向马先生介绍,可以为其办理退保,并帮忙购买收益更高的理财产品。原来,马先生在某保险公司办理了长期保险,交了6年后发现不划算,由于自己做生意周转出现困难,看到网上有代办“全额退款”的信息后,便联系到了该名业务员。对方声称,只要提供相关的证件及保单,将在15天内通过自己的渠道帮助马先生办理“全额退保”业务。退保成功后,业务人员将收取保费的30%作为佣金。

  After signing the "Insurance Consulting Service Agreement" with the salesman, Mr. Ma provided the salesperson with his bank card, ID card, insurance policy and other information, and according to the other party's request, he did not answer the insurance company's phone calls, or asked to answer the phone. Said that "there was a misunderstanding of the insurance clauses when I bought the insurance, and it was not an expression of my true intentions".

About 10 days later, Mr. Ma successfully surrendered the policy and signed a "Supplementary Dividend Agreement" with the salesman to cover the surrender loss.

Mr. Ma later learned that the clerk used a formatted complaint letter to the insurance supervision department and called the insurance company's hotline every day to request a full refund.

  Later, the salesman told Mr. Ma that the original contract was to charge 30% of the premium as a commission, but now he can only charge 10%, because he felt that the level of insurance coverage Mr. Ma had purchased before was too low, and he could assist him in surrendering the insurance. The premium is used to purchase a dividend-paying insurance wealth management product with an annual yield of around 15%.

Mr. Ma then used 70% of the surrender fee to buy a "high-return" wealth management product, but later found out that the wealth management product would not be redeemed until 10 years later, and the right to use the money within ten years would not be available. belong to myself.

  "Professional third parties and insiders of insurance companies illegally obtain insurance customer information, mislead or encourage insurance customers to surrender their policies abnormally." Wang Chunmei said that the "surrender and wealth management" routines are often those that have a negative impact on existing insurance policies. Consumers who are dissatisfied with insurance income or have financial difficulties are easy to be recruited; and some insurance companies who leave their jobs will contact consumers in the name of "policy dividends", "dividend upgrades", and "after-sales service", saying that the insurance products they have purchased are of low value. Induce consumers to apply for surrender or pledge of policy, and switch to their recommended "high-yield" wealth management products.

  Some consumers are unfamiliar with insurance wealth management products, and some insurance companies are not strict in the management of customer information, which leads to the leakage of customer information, allowing these "salesmen" to get in touch with consumers.

They will grasp the psychology of consumers who find that the income does not meet expectations after they apply for insurance, and inform them that they can obtain high income through surrender and reinvestment, and consumers are often moved. For insurance companies, it takes time for each complaint to be processed. The cost and labor cost are very high, and in many cases, the authenticity cannot be immediately distinguished.

In order to avoid escalation of disputes, it is often only possible to agree to surrender requests.

  Wang Chunmei said that because of the frequent cases of surrender and wealth management cases, "abnormal surrender" was included in the key areas of rectification by the China Banking and Insurance Regulatory Commission last year.

  What are the pitfalls in buying insurance?

  Verbal promises, bundled consumption, hunger marketing…

  在杨丰禹和王春梅看来,不止是财产险“套路”多,在互联网时代,保险消费中的“坑”确实不少。

  1 合同之外的利益

  首先明显的一个“坑”就是在合同之外口头承诺的“利益”。“不少财产险产品为了走量,给予客户一些合同之外的利益是常见的做法。而这些‘好处’都是口头承诺,不能写进合同,有时还可能兑现不了,因此而起纠纷的情况非常普遍。”王春梅说。

  据了解,合同约定之外的利益无非三种方式,一是以现金形式返现;二是给实物,比如送加油卡、美容卡等,三是增值服务。“比如说,保单上虽然写着保费是1000元,但有一家保险公司说给你便宜50块钱,还给你送200块钱加油卡,你可能就同意了。这种做法持续下去,会把整个市场搞乱了。”在杨丰禹看来,消费者虽然得到了一些实惠,但最终“羊毛出在羊身上”。

  2 欺骗被保险人

  实际上,很多消费者在买保险时很难逐字逐句对保险条款进行细读,尤其是一些老年人,对保险条款是一知半解,在购买长期险和一些带有理财性质的保险产品时,往往容易对保险条款存在误解。比如原本以为自己符合赔付条件,但最终却因为不熟知条款而没能触发赔付;又如一款带有理财性质的保险产品,保险公司告诉消费者年化收益率能超过10%,隐瞒保单收益的不确定性,可最后这款产品未必能保本;或是在客户购买保险产品时,业务员说保证百分之百理赔,但真的出了事想找保险公司救急时,未必能顺利理赔。

  3 诱导消费者购买保险产品

  早在2010年,银监会曾发文叫停保险驻点销售,其中提到保险销售过程中不得将保险产品与储蓄存款、国债、银行理财产品等混淆,不得套用本金、利息、存入等概念,将保险产品的收益与银行存款、国债、理财产品收益等进行片面对比。但实际上,这种通过片面对比来诱导消费者的情况并不少见。比如销售人员为达成保险合同,未向消费者如实告知保险风险、披露保单信息;以其他金融产品名义宣传保险产品;夸大保险责任或收益,夸大保险保障范围来诱导消费者购买等。

  4 捆绑销售

  保险与网贷平台合作,搭“顺风车”捆绑销售也是常见的“坑”。在互联网保险方面,存在网络销售中限制消费者自由选择权的情况。如与第三方网络借款平台合作,强制消费者在借款过程中投保意外险、保证保险等,若不投保则无法办理借款。

  5 饥饿营销

  饥饿营销也是保险消费中常见的“坑”。保监会曾明确规定保险公司“不得以停止使用保险条款和保险费率的名义进行宣传炒作及销售误导”,但此类“饥饿营销”却仍然存在。比如某保险公司在向投资者销售一款年金保险产品时宣称活动限时、限量、限人、限额,给消费者造成这款产品回报率极高、供不应求的印象。后来证明,该款产品只不过是借助“饥饿营销”而进行的虚假宣传。

  买保险如何避“坑”?

  收益超5%要存疑 买保险时可要求“双录”

  消费者在购买保险时如何才能“避坑”?杨丰禹和王春梅给出了自己的建议。

  对“高收益”保持警惕

  杨丰禹表示,首先,对保险公司的理财产品要保持高度警惕,年收益超过5%的几乎可以不信。他表示,保险的首要功能是保障,而非收益。“可以这么说,在保险行业要找出一款年化收益率在5%以上的带理财功能的产品非常难。比如说某款带理财功能的保险产品,期限为5年,5万元起购,宣称收益最高可达5%。而事实上该收益只是预期最高收益,保息只是保底收益2%,收益基本与定存持平,更高的收益能否实现完全没有保障。所以,消费者要警惕隐瞒风险、模糊费用等虚假宣传套路,根据自身风险承受能力和需求购买。”

  认准正规渠道购买

  其次,保险消费者应从正规机构、规范渠道,根据自身需求和消费能力购买金融产品或服务。不要因为“免费”“零首付”“限时”等营销宣传套路而轻率购买自己不了解、不必要的金融产品。很多保险受骗者都是通过非正规渠道购买保险,比如说花了数十万元买了所谓“高额回报”且保底的理财产品,结果最终血本无归。

  确保全程可回溯

  Third, make sure that the entire purchase process of insurance products can be traced back.

Yang Fengyu said that many insurance companies now have to conduct "double recording" when selling products: audio and video.

"How does the insurance agent introduce this product to the customer, to realize the retrospective mechanism of the sales product. If there is a dispute, you can check the video to know what happened. The same is true for Internet products, and it is also necessary to achieve double recording. Especially those that are prone to ambiguity or misunderstanding, long-term insurance or property insurance of an investment nature.”

  Try to choose a large insurance company

  As a financial planner, Wang Chunmei suggested that the purchase of insurance should be based on pure protection insurance products, supplemented by accident insurance and critical illness insurance.

The premium is generally 10% of an individual's annual income.

And try to choose a large insurance company.

On the whole, the business development of small insurance companies is not as compliant as that of large companies, and it is difficult to obtain protection when problems arise later.

  Wang Chunmei said that at present some small insurance company agents are not only the company's sales staff, but also the company's users.

After the insurance agent joins the insurance company, in order to complete the performance, he first buys it himself, and then asks family members, relatives and friends to buy it.

The "pulling people's head" model not only makes the agent consume favor and overdraw trust, but also makes the insurance industry branded as a "liar". Even as high as level 10, although the agents at the bottom of the pyramid are the main sales force, but the income is "pumped" layer by layer, and the final income is not much.

This is also the reason for the large loss of personnel in the insurance industry.

"For some small insurance companies, the annual turnover of personnel is more than 30%. In my personal experience, less than 50% of insurance agents can work in a company for more than 5 years."

  Read the contract terms carefully

  Wang Chunmei believes that the most important thing before buying insurance is to carefully read the terms of the insurance contract.

Based on her previous experience with an insurance company, about 40% of claims for compensation will be rejected every year. An important reason is that insurance companies and consumers have differences in their understanding of insurance terms.

"When this happens, it may be deliberately done by the insurance company, or it may be due to the consumer's misunderstanding." She warned consumers that if they heard "one policy can cover everything" when buying insurance, "this insurance can have Do not believe the introductions such as treating the disease, and returning the money if you are not sick.

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