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Notice by the General Office of the China Banking and Insurance Regulatory Commission of the Off-site Inspection of Clauses and Rates of Products of Property Insurance Companies Granted Recordation [Effective]
中国银保监会办公厅关于财产保险公司备案产品条款费率非现场检查问题情况的通报 [现行有效]
【法宝引证码】

Notice by the General Office of the China Banking and Insurance Regulatory Commission of the Off-site Inspection of Clauses and Rates of Products of Property Insurance Companies Granted Recordation 

中国银保监会办公厅关于财产保险公司备案产品条款费率非现场检查问题情况的通报

(No. 157 [2019] of the General Office of the China Banking and Insurance Regulatory Commission) (银保监办发〔2019〕157号)

All property insurance companies: 各财产保险公司:
For the purposes of further standardizing the administration of product development of property insurance companies, solidifying companies' subject responsibility for product management, enhancing the overall quality of industry products, and effectively protecting the lawful rights and interests of insurance consumers, the China Banking and Insurance Regulatory Commission (“CBIRC”) has organized the second product inspection on the basis of companies' self-inspection and rectification and the first off-site inspection of clauses and rates of products of property insurance companies granted recordation. The product inspection adhered to problem orientation, focused on prominent problems found in daily supervision, and comprehensively inspected 1,550 family property insurance, liability insurance and short-term health insurance products of 20 property insurance companies. In response to the problems found in inspection, the CBIRC will issue a decision on administrative regulatory measures to 20 property insurance companies, order companies to immediately cease the use of defective products, take rectification within a prescribed time limit, and take the regulatory measure of prohibiting 11 companies with serious circumstances from filing new products granted recordation for three to six months. The main problems found in product inspection are hereby announced as follows: 为进一步规范财产保险公司产品开发管理行为,压实公司产品管理主体责任,提升行业产品整体质量,切实保护保险消费者合法权益,在公司自查整改和第一次财产保险公司备案产品条款费率非现场检查的基础上,我会组织开展了第二次产品检查。此次产品检查坚持问题导向,以日常监管中发现的突出问题为重点,对20家财险公司的1550个家庭财产保险、责任保险和短期健康保险产品进行全面检查。针对检查发现的问题,我会向20家财产保险公司下发行政监管措施决定书,责令公司立即停止使用问题产品,限期整改,并对其中情节严重的11家公司采取禁止申报新备案产品3至6个月的监管措施。现将产品检查发现的主要问题通报如下:
I. Issues on Insurance Clauses   一、保险条款方面问题
(1) The naming of insurance clauses is not standardized and fails to comply with the naming rules of the Guidelines for the Development of Insurance Products of Property Insurance Companies. For instance, the naming of some additional risk clauses lacks the clear indication of “additional”. (一)保险条款名称命名不规范,不符合《财产保险公司保险产品开发指引》命名规则。如有的附加险条款命名缺少“附加”的明确标识。
(2) There is a gap between insurance clauses and the requirements of “clear structure, accurate texts, rigorous expression, and easy to understand”. For instance, the liability in some clauses is unclear, unspecific or broadly stated, or liability exemption clauses, deductibles, excess, proportional claims and payment, or other clauses that exempt or reduce the liability of the insurer do not use words, fonts or symbols sufficient to attract the attention of the insured or other clear signs to make a reminder. (二)保险条款与“结构清晰、文字准确、表述严谨、通俗易懂”要求有差距。如有的条款责任不清晰、不明确、表述宽泛,责任免除条款、免赔额、免赔率、比例赔付给付等免除或者减轻保险人责任的条款,未使用足以引起投保人注意的文字、字体、符号或者其他明显标志作出提示。
(3) The terms on the rescission of a contract in insurance clauses are not rigorous and standardized enough. For instance, some accident insurance or short-term health insurance clauses cover the circumstance that insurance premiums are returned when the insurance applicant or the insured intentionally causes an insured accident; and some clauses do not have surrender treatment provisions or have irrational surrender provisions. (三)保险条款解除合同约定不严谨、不规范。如有的意外险、短期健康险条款存在投保人或被保险人故意制造保险事故情形下退还保费的情况;有的条款存在缺少退保处理规定或退保规定不合理的情况。
(4) Introducing long-term insurance concepts in short-term health insurance. For instance, some have long-term health insurance concepts such as “automatic renewal” or “lifetime limit”. (四)短期健康保险中引入长期保险概念。如有的出现“自动续保”或“终身限额”等长期健康保险概念。
(5) Introducing repealed standards in short-term health insurance or liability insurance clauses. For instance, the repealed standards Assessment of Working Capacity and Grades of Employees' Disabilities Caused by Work-Related Injuries and Occupational Diseases (GB/Tl6180-2006) are cited in some clauses. (五)短期健康保险或责任保险条款引用已经废止的标准。如有的条款中引用已经废止的《劳动能力鉴定职工工伤与职业病致残等级》(GB/Tl6180-2006)标准。
(6) Relevant standards are not cited in insurance clauses in a standard manner. When the Assessment Criteria for Injuries and Disability in Personal Insurance issued by the Insurance Association of China are cited in some clauses, the full name, issuer, document number and standard number of the industry standard are not cited as required.
......
 (六)保险条款未规范引用相关标准。如有的条款中引用中国保险行业协会发布的《人身保险伤残评定标准》时,未按规定要求引用该行业标准的全称、发布机构、发文号及标准编号。
......

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