According to the circular, in the product verification, the CBRC has reported a number of problems found in product design, product term formulation, product rate determination and other aspects.
On the issue of product design, one is that the product responsibility design does not conform to the product definition. For example, Ying Datai and a disease insurance, insurance liability includes survival gold payment liability, and disease insurance does not agree with the definition; the second is the weakening of product protection function. For example, harmonious health, PICC health a nursing insurance, the product is universal, nursing responsibility risk premium as a low proportion of the overall premium.
The first is that the terms are not in accordance with the provisions of the law. For example, the terms of some products of Ruitai Life, Ruihua Health, Sino-German Allianz, Guohua Life, etc., concerning the scope of the court with jurisdiction, are not in accordance with the provisions of the Civil Procedure Law of the People's Republic of China on regional jurisdiction. Second, the terms are unclear. For example, Xinmei Mutual and China Merchants and a medical insurance, the product is a one-year non-guaranteed renewal product, but the renewal clause contains \"automatic renewal\" expression, there is a \"short risk long do\" risk. Third, clause expression is easy to cause disputes. For example, some of the health insurance products submitted by Huaxia Life, PICC Health, China Merchants Xinnuo, Haibao Life Insurance, Sino-American Union of Thailand, Sino-Italian Life, Fosun United Health and Dehuaan Gu, etc., are stipulated in the terms and conditions that the symptoms or signs of the waiting period will be used as the basis for exemption from the occurrence of insurance accidents after the waiting period, and the symptoms and signs are not objectively judged to infringe upon the interests of consumers.
On the issue of product rate determination, short-term health insurance products have a rate adjustment statement. For example, a health insurance policy for Pacific Life contains a statement that the product rate may be adjusted at the time of renewal, which is not in accordance with the requirements of the Health Insurance Regulations.
There are other issues such as non-standard filing materials and non-standard filing materials. For example, some of the materials submitted by a certain 2 health insurance products do not belong to the category of product filing materials; the solvency data in the information table of Fuxing joint health report of a certain 5 products, the information table of fee change information does not distinguish between comprehensive and core solvency adequacy ratio; Taiping pension a major disease insurance, fee change information table in the company investment income data has not been updated in the last five years.
The CBRC also found in its on-site investigation that between March and mid-May 2019, Haibao Life, through Yi Kangji Insurance Brokerage Co., Ltd., had two problems in the process of selling good life borrowers'accidental injury insurance on the network platform of Shenzhen Handy Technology Co., Ltd.:
First, not only according to the region, occupation and other factors to carry out rate fluctuations, but also refer to the customer's borrowing period, loan amount, assets, credit status and other factors, not completely in accordance with the insurance clause on record to manage the rate fluctuations.
The second is that the commission rate agreed with the Yi Kang Ji is significantly higher than the expected rate in the actuarial report. Haibao Life has rectified the above problems and carried out internal accountability to the relevant responsible persons.
The CBRC pointed out that new requirements for health insurance business were put forward after the implementation of the Health Insurance Management Measures (CBRC Order No.3 of 2019). Under the Health Insurance Regulations and other regulatory provisions, companies should focus on the following four issues:
Second, health insurance products with insurance renewal clauses should state in the product actuarial report the pricing treatment method and liability reserve calculation method for the guaranteed renewal.
Third, insurance companies to sell health insurance products, may not be forced to match other products to sell. Some companies have stipulated in the terms that consumers are not allowed to release the additional insurance separately, or have agreed that the insurance payment of the product is conditional on whether the insurance payment of other products is paid or not, which is suspected of harming the interests of consumers.
Fourth, the statement of the chief actuary and the statement of the legal responsible person in the product filing materials should be adjusted according to the latest name after the institutional reform.
The CBRC stressed that all personal insurance companies should strengthen the standardized management of product development, conduct self-inspection in strict reference to the contents of previous circulars, and strengthen the examination and control of the formulation of product terms and rates, so as to ensure that products comply with the law. All companies should attach great importance to the protection of consumers'rights and interests, must not set unreasonable exemption clauses to narrow the scope of insurance liability, must not set unreasonable agreements to restrict consumers'legal rights, and must not set unreasonable terms to provide convenience for misleading sales.
At the same time, all personal insurance companies shall not use the contents of the circular to discredit the industry, and shall not use the contents of the circular as a marketing hype and unfair competition tool. Those who violate the relevant regulations have adverse effects, the CBRC will seriously investigate the responsibility of the relevant companies and information dissemination personnel. (For more original information, please download the \"Surging News\" app)