I have summarized the experience of compliance management, and the experience introduction materials should be explained in detail in combination with your company's situation. The following contents are for your reference only.
(1) business development
(1) Strictly implement the unified legal person system and strictly authorize management;
(two) strictly implement the terms and rates approved or filed by the insurance regulatory authorities, and it is strictly forbidden to set the wrong terms or reduce fees in disguise for the purpose of competition; Bear the corresponding insurance liabilities as required;
(3) Adhere to strict declaration procedures and operate according to the approved opinions;
(4) Strictly implement the relevant provisions of off-site, all-inclusive, joint guarantee and * * * guarantee business, and perform the corresponding approval and filing procedures.
(5) Strictly implement the pure risk loss rate and calculate the utilization rate according to the pure risk rate;
(six) the examination and approval of the refund work meets the relevant requirements, put an end to illegal examination and approval or reduction of premiums, and conduct examination and approval of the refund in strict accordance with the examination and approval opinions;
(7) Strict management of insurance-related laws and regulations.
(2) Financial management:
(1) Truthfully reflect premium income in strict accordance with the new accounting standards and the principle of premium income recognition; There is no such phenomenon as "small treasury" and "off-balance-sheet account";
(2) Failing to pass the non-financial account or falsely hanging the premium receivable and falsely listing the expense cost through the account;
(3) Managing funds in strict accordance with the relevant provisions of the Measures for the Administration of Funds; In strict accordance with the "two lines of revenue and expenditure" fund management regulations, all fund revenues and expenditures are all included in the account accounting; Put an end to the phenomenon of storing cash beyond the limit, using cash beyond the scope, and "white bars coming to the warehouse";
(4) Standardize the provision, use and management of claims expenses in strict accordance with financial management regulations; There is no phenomenon of collecting exhibition fees and administrative office fees to reimburse expenses;
(five) the operating costs are collected according to the facts, and the financial data are true and accurate;
(six) according to the provisions of various liabilities; The reserve data is true and accurate;
(7) There are no violations such as tearing bills and paying bills, yin and yang policies, system billing, and net premiums.
(3) claim management:
(1) Handle claims according to the policy, and put an end to malicious delay, refusal to pay, unreasonable refusal to pay and other behaviors that harm the rights and interests of customers;
(2) There is no act of deliberately fabricating insurance accidents that have never happened to make false claims, and it is strictly forbidden to deliberately expand the scope of insurance accident losses and falsely increase the amount of compensation; Put an end to the phenomenon that expenses unrelated to compensation cases are included in compensation cases and collected;
(3) There are no illegal acts such as conspiring with other units to defraud compensation;
(4) Constantly establish and improve claims service standards; On the premise of ensuring the quality of claims, we will conscientiously implement the work of simplifying claims documents and optimizing claims workflow.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.