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| Measures for the Administration of Insurance Clauses and Premium Rates of Personal Insurance Companies | | 人身保险公司保险条款和保险费率管理办法 |
| (Issued by Order No. 3 [2011] of the China Insurance Regulatory Commission on December 30, 2011; and revised in accordance with the Decision of the China Insurance Regulatory Commission to Amend Eight Sets of Departmental Rules Including the Measures for the Administration of the Formation of Overseas Insurance Institutions by Insurance Companies by Order No. 3 [2015] of the China Insurance Regulatory Commission on October 19, 2015) | | （2011年12月30日中国保险监督管理委员会令2011年第3号发布 根据2015年10月19日中国保险监督管理委员会令2015年第3号《关于修改＜保险公司设立境外保险类机构管理办法＞等八部规章的决定》修订） |
| Chapter I General Provisions | | 第一章 总 则 |
| Article 1 To strengthen the regulation of insurance clauses and premium rates of personal insurance companies (hereinafter referred to as the “insurance companies”), protect the lawful rights and interests of insurance applicants, insureds, and beneficiaries, maintain the competitive order of the insurance market, and encourage innovation by insurance companies, these Measures are developed in accordance with the Insurance Law of the People's Republic of China (hereinafter referred to as the “Insurance Law”) and other relevant laws and administrative regulations. | | 第一条 为了加强人身保险公司（以下简称保险公司）保险条款和保险费率的监督管理，保护投保人、被保险人和受益人的合法权益，维护保险市场竞争秩序，鼓励保险公司创新，根据《中华人民共和国保险法》（以下简称《保险法》）等有关法律、行政法规，制定本办法。 |
| Article 2 The China Insurance Regulatory Commission (CIRC) shall, according to the law, regulate the insurance clauses and premium rates of insurance companies. The local offices of the CIRC shall exercise powers as delegated by the CIRC. | | 第二条 中国保险监督管理委员会（以下简称中国保监会）依法对保险公司的保险条款和保险费率实施监督管理。中国保监会派出机构在中国保监会授权范围内行使职权。 |
| Article 3 Insurance companies shall draft fair and reasonable insurance clauses and premium rates in accordance with the Insurance Law and the relevant CIRC provisions without prejudice to the lawful rights and interests of insurance applicants, insureds, and beneficiaries. Insurance companies shall assume corresponding responsibility for their drafted insurance clauses and premium rates. | | 第三条 保险公司应当按照《保险法》和中国保监会有关规定，公平、合理拟订保险条款和保险费率，不得损害投保人、被保险人和受益人的合法权益。保险公司对其拟订的保险条款和保险费率承担相应责任。 |
| Article 4 Insurance companies shall submit their insurance clauses and premium rates to the CIRC for approval or recordation pursuant to these Measures. | | 第四条 保险公司应当按照本办法规定将保险条款和保险费率报送中国保监会审批或者备案。 |
| Article 5 Insurance companies shall establish a scientific and efficient personal insurance development management mechanism that meets the market demand to track and analyze their operations on a regular basis, discover issues related to insurance clauses and premium rates in their operations and management in a timely manner and take appropriate measures to address such issues. | | 第五条 保险公司应当建立科学、高效、符合市场需求的人身保险开发管理机制，定期跟踪和分析经营情况，及时发现保险条款、保险费率经营管理中存在的问题并采取相应解决措施。 |
| Article 6 Insurance companies shall maximize their core competitiveness, rationally allocate company resources, and develop their types of insurance products in light of macroeconomic policies, market demand, and their strategic objectives. | | 第六条 保险公司应当充分发挥核心竞争优势，合理配置公司资源，围绕宏观经济政策、市场需求、公司战略目标开发保险险种。 |
| Chapter II Design and Classification | | 第二章 设计与分类 |
| Article 7 Personal insurance shall be divided into life insurance, annuity insurance, health insurance, and accidental injury insurance. | | 第七条 人身保险分为人寿保险、年金保险、健康保险、意外伤害保险。 |
| Article 8 Life insurance means personal insurance with the life of a person as the subject matter insured, including but not limited to term life insurance, whole life insurance, and endowment insurance. | | 第八条 人寿保险是指以人的寿命为保险标的的人身保险。人寿保险分为定期寿险、终身寿险、两全保险等。 |
| Term life insurance is life insurance with a fixed duration in which the payment of insurance benefit is conditioned upon the death of the insured. | | 定期寿险是指以被保险人死亡为给付保险金条件，且保险期间为固定年限的人寿保险。 |
| Whole life insurance is life insurance with a whole life duration in which the payment of insurance benefit is conditioned upon the death of the insured. | | 终身寿险是指以被保险人死亡为给付保险金条件，且保险期间为终身的人寿保险。 |
| Endowment insurance is life insurance in which the payment of insurance benefit is conditioned upon both the death and the survival of the insured. | | 两全保险是指既包含以被保险人死亡为给付保险金条件，又包含以被保险人生存为给付保险金条件的人寿保险。 |
| Article 9 Annuity insurance means personal insurance in which the payment of insurance benefit is conditioned upon the survival of the insured and the survival benefit is paid in installments at an agreed interval. | | 第九条 年金保险是指以被保险人生存为给付保险金条件，并按约定的时间间隔分期给付生存保险金的人身保险。 |
| Article 10 Pension annuity insurance is annuity insurance for old-age security. Pension annuity insurance shall meet the following conditions: | | 第十条 养老年金保险是指以养老保障为目的的年金保险。养老年金保险应当符合下列条件： |
| (1) The age agreed upon in the insurance contract for paying survival benefit to the insured is not lower than the retiring age prescribed by the state. | | （一）保险合同约定给付被保险人生存保险金的年龄不得小于国家规定的退休年龄； |
| (2) The interval between two consecutive payments does not exceed one year. | | （二）相邻两次给付的时间间隔不得超过一年。 |
| Article 11 Health insurance means personal insurance in which the payment of insurance benefit is conditioned upon losses incurred for health reasons, including but not limited to disease insurance, medical insurance, disability income insurance, and health care insurance. | | 第十一条 健康保险是指以因健康原因导致损失为给付保险金条件的人身保险。健康保险分为疾病保险、医疗保险、失能收入损失保险、护理保险等。 |
| Disease insurance is health insurance in which the payment of insurance benefit is conditioned upon the occurrence of a disease agreed upon in the insurance contract. | | 疾病保险是指以保险合同约定的疾病发生为给付保险金条件的健康保险。 |
| Medical insurance is health insurance in which the payment of insurance benefit is conditioned upon the occurrence of a medical activity agreed upon in the insurance contract to cover as agreed upon the insured's medical expenses during receipt of treatment. | | 医疗保险是指以保险合同约定的医疗行为发生为给付保险金条件，按约定对被保险人接受诊疗期间的医疗费用支出提供保障的健康保险。 |
| Disability income insurance is health insurance in which the payment of insurance benefit is conditioned upon the loss of working ability caused by a disease or accidental injury agreed upon in the insurance contract to cover as agreed upon any income decrease or interruption of the insured during a certain period. | | 失能收入损失保险是指以因保险合同约定的疾病或者意外伤害导致工作能力丧失为给付保险金条件，按约定对被保险人在一定时期内收入减少或者中断提供保障的健康保险。 |
| Health care insurance is health insurance in which the payment of insurance benefit is conditioned upon the occurrence of a care need caused by any daily living handicap agreed upon in the insurance contract to cover as agreed upon the health care expenses of the insured. | | 护理保险是指以因保险合同约定的日常生活能力障碍引发护理需要为给付保险金条件，按约定对被保险人的护理支出提供保障的健康保险。 |
| Article 12 Accidental injury insurance means personal insurance in which the payment of insurance benefit is conditioned upon the occurrence of an accident resulting in the death or disability of the insured or the occurrence of any other accident as agreed upon in the insurance contract. | | 第十二条 意外伤害保险是指以被保险人因意外事故而导致身故、残疾或者发生保险合同约定的其他事故为给付保险金条件的人身保险。 |
| Article 13 Life insurance and health insurance may cover total disability liability. | | 第十三条 人寿保险和健康保险可以包含全残责任。 |
| Where health insurance includes two or more kinds of health coverage, the primary liability shall be determined according to general actuarial principles, and the insurance type shall be determined based on the primary liability. The disease insurance in long-term health insurance may cover death insurance liability, but the amount of death benefit shall not exceed the maximum benefit amount for diseases. Other health insurance may not cover death insurance liability, except death insurance liability resulting from a disease. | | 健康保险包含两种以上健康保障责任的，应当按照一般精算原理判断主要责任，并根据主要责任确定险种类别。长期健康保险中的疾病保险，可以包含死亡保险责任，但死亡给付金额不得高于疾病最高给付金额。其他健康保险不得包含死亡保险责任，但因疾病引发的死亡保险责任除外。 |
| Medical insurance and disease insurance may not cover pure endowment insurance liability. | | 医疗保险和疾病保险不得包含生存保险责任。 |
| Accidental injury insurance may cover medial insurance liability resulting from accidental injuries. Insurance only covering medical insurance liability resulting from accidental injuries shall be determined as medical insurance. | | 意外伤害保险可以包含由意外伤害导致的医疗保险责任。仅包含由意外伤害导致的医疗保险责任的保险应当确定为医疗保险。 |
| Article 14 Insurance companies shall strictly comply with the classification standards for life insurance, annuity insurance, health insurance, and accidental injury insurance in these Measures, except as otherwise specified by the CIRC. | | 第十四条 保险公司应当严格遵循本办法所规定的人寿保险、年金保险、健康保险、意外伤害保险的分类标准，中国保监会另有规定的除外。 |
| Article 15 Personal insurance shall be named in the following format: | | 第十五条 人身保险的定名应当符合下列格式： |
| “Name of insurance company” + “auspicious or descriptive words” + “insurance type” + “(design type)” | | "保险公司名称"＋"吉庆、说明性文字"＋"险种类别"＋"（设计类型）" |
| The “Name of insurance company” in the preceding paragraph may be the full or abbreviated name of an insurance company; and the number of auspicious or descriptive words may not exceed 10. | | 前款规定的保险公司名称可用全称或者简称；吉庆、说明性文字的字数不得超过10个。 |
| For additional coverage, “additional” shall be affixed after the “name of insurance company.” | | 附加保险的定名应当在"保险公司名称"后标注"附加"字样。 |
| For group insurance, “group” shall be indicated in the name. | | 团体保险应当在名称中标明"团体"字样。 |
| Article 16 The insurance type of pension annuity insurance in annuity insurance is “pension annuity insurance,” while that of other annuity insurance is “annuity insurance”; and the insurance type of accidental injury insurance is “accidental injury insurance.” | | 第十六条 年金保险中的养老年金保险险种类别为"养老年金保险"，其他年金保险险种类别为"年金保险"；意外伤害保险险种类别为"意外伤害保险"。 |
| Article 17 The design types of personal insurance shall include but not be limited to general type, participating type, unit-linked type, and universal type. | | 第十七条 人身保险的设计类型分为普通型、分红型、投资连结型、万能型等。 |
| Article 18 The design types of participating, unit-linked, and universal personal insurance shall be indicated in the name, while that of general personal insurance need not be indicated in the name. | | 第十八条 分红型、投资连结型和万能型人身保险应当在名称中注明设计类型，普通型人身保险无须在名称中注明设计类型。 |
| Chapter III Approval and Recordation | | 第三章 审批与备案 |
| Article 19 The head office of an insurance company shall be responsible for submitting insurance clauses and premium rates to the CIRC for approval or recordation. | | 第十九条 保险公司总公司负责将保险条款和保险费率报送中国保监会审批或者备案。 |
| Article 20 Insurance companies shall submit the insurance clauses and premium rates of the following types of insurance to the CIRC for approval before use: | | 第二十条 保险公司下列险种的保险条款和保险费率，应当在使用前报送中国保监会审批： |
| (1) Types of insurance involving the public interest. | | （一）关系社会公众利益的保险险种； |
| (2) Types of insurance which is compulsory according to the law. | | （二）依法实行强制保险的险种； |
| (3) Types of newly developed life insurance as set out by the CIRC. | | （三）中国保监会规定的新开发人寿保险险种； |
| (4) Other types of insurance as set out by the CIRC. | | （四）中国保监会规定的其他险种。 |
| The types of insurance other than those in the preceding paragraph shall be reported to the CIRC for recordation. | | 前款规定以外的其他险种，应当报送中国保监会备案。 |
| Article 21 An insurance company which reports insurance clauses and premium rates to the CIRC for recordation shall submit: | | 第二十一条 保险公司报送保险条款和保险费率备案的，应当提交下列材料： |
| (1) a Checklist for a Personal Insurance Company to Report Insurance Clauses and Premium Rates for Recordation; | | （一）《人身保险公司保险条款和保险费率备案报送材料清单表》； |
| (2) insurance clauses; | | （二）保险条款； |
| (3) a schedule of premium rates; | | （三）保险费率表； |
| (4) a relevant actuary report signed by the appointed actuary; | | （四）总精算师签署的相关精算报告； |
| (5) a written statement of the appointed actuary; | | （五）总精算师声明书； |
| (6) a written statement of the appointed legal counsel; and | | （六）法律责任人声明书； |
| (7) other materials as set out by the CIRC. | | （七）中国保监会规定的其他材料。 |
| Article 22 An insurance company which reports the insurance clauses and premium rates of participating insurance, unit-linked insurance, or universal insurance shall, in addition to those required in Article 21, submit: | | 第二十二条 保险公司报送分红保险、投资连结保险、万能保险保险条款和保险费率备案的，除提交第二十一条规定的材料以外，还应当提交下列材料： |
| (1) financial management measures; | | （一）财务管理办法； |
| (2) business management measures; | | （二）业务管理办法； |
| (3) information disclosure management rules; | | （三）信息披露管理制度； |
| (4) business plans and their effects on solvency; and | | （四）业务规划及对偿付能力的影响； |
| (5) product brochures. | | （五）产品说明书。 |
| For participating insurance, the measures for calculating and distributing dividends as well as the principles for allocating income and amortizing expenses shall also be submitted; and for unit-linked insurance or universal insurance, the sales management measures including but not limited to marketing channels and sales territories shall also be submitted. | | 分红保险，还应当提交红利计算和分配办法、收入分配和费用分摊原则；投资连结保险和万能保险，还应当提交包括销售渠道、销售区域等内容的销售管理办法。 |
| If any of the above materials to be submitted by an insurance company is identical with the corresponding material for the same type of insurance of the company already approved or recorded by the CIRC, the submission of the material may be waived, but the waiver shall be noted in the Checklist. | | 保险公司提交的上述材料与本公司已经中国保监会审批或者备案的同类险种对应材料完全一致的，可以免于提交该材料，但应当在材料清单表中予以注明。 |
| Article 23 An insurance company which submits insurance clauses and premium rates for approval shall, in addition to those required in items (2) to (7) of Article 21 and in Article 22, submit: | | 第二十三条 保险公司报送保险条款和保险费率审批的，除提交第二十一条第（二）项至第（七）项以及第二十二条规定的材料外，还应当提交下列材料： |
| (1) a completed Application Form for the Approval of Insurance Clauses and Premium Rates of a Personal Insurance Company; | | （一）《人身保险公司保险条款和保险费率审批申请表》； |
| (2) a Checklist for a Personal Insurance Company to Report Insurance Clauses and Premium Rates for Approval; and | | （二）《人身保险公司保险条款和保险费率审批报送材料清单表》； |
| (3) explanations of insurance clauses and premium rates, including but not limited to their major characteristics, market risk and operating risk analysis, and corresponding management and control measures. | | （三）保险条款和保险费率的说明材料，包括保险条款和保险费率的主要特点、市场风险和经营风险分析、相应的管控措施等。 |
| Article 24 An insurance company which submits the following insurance clauses and premium rates for approval or recordation shall, in addition to those required in Articles 21, 22, and 23 respectively, submit: | | 第二十四条 保险公司报送下列保险条款和保险费率审批或者备案的，除分别按照第二十一条、第二十二条、第二十三条规定报送材料以外，还应当按照下列规定提交材料： |
| (1) if there is a cash value, written materials including cash value illustrations and electronic documentation including a whole cash value table for each age; | | （一）具有现金价值的，提交包含现金价值表示例的书面材料以及包含各年龄现金价值全表的电子文档； |
| (2) if there is a reduced paid-up clause, written materials including reduced paid-up premium illustrations and electronic documentation including a whole reduced paid-up premium table for each age; | | （二）具有减额交清条款的，提交包含减额交清保额表示例的书面材料以及包含各年龄减额交清保额全表的电子文档； |
| (3) if rate floating or parameter adjustment is permitted by the CIRC, rate floating management measures or product parameter adjustment measures signed by the appointed actuary; and | | （三）中国保监会允许费率浮动或者参数调整的，提交由总精算师签署的费率浮动管理办法或者产品参数调整办法； |
| (4) if the insurance duration exceeds one year, electronic documentation on profit testing models. | | （四）保险期间超过一年的，提交利润测试模型的电子文档。 |
| Article 25 Where an insurance company submits insurance clauses and premium rates for approval or recordation, the actuary report submitted shall, at a minimum, include: | | 第二十五条 保险公司报送保险条款和保险费率审批或者备案的，提交的精算报告至少应当包括下列内容： |
| (1) data sources and pricing basis; | | （一）数据来源和定价基础； |
| (2) pricing methods and pricing assumptions; and if the insurance duration exceeds one year, profit testing parameters, profit testing results, and sensitivity analysis of changes in key parameter; | | （二）定价方法和定价假设，保险期间超过一年的，还应当包括利润测试参数、利润测试结果以及主要参数变化的敏感性分析； |
| (3) computing methods for statutory reserves; | | （三）法定准备金计算方法； |
| (4) major risks and corresponding management opinions; | | （四）主要风险及相应管理意见； |
| (5) matters requiring special mention by the appointed actuary; and | | （五）总精算师需要特别说明的内容； |
| (6) other matters as set out by the CIRC. | | （六）中国保监会规定的其他内容。 |
Article 26 Where an insurance company submits the following insurance clauses and premium rates for approval or recordation, the actuary report submitted shall, in addition to Article 25 of these Measures, comply with the following provisions:
．．．．．． | | 第二十六条 保险公司报送下列保险条款和保险费率审批或者备案的，提交的精算报告除符合第二十五条规定外，还应当符合下列规定：
．．．．．． |
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