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触碰“134号文”雷区 多款保险新品申报被“打回”

2017-09-14 07:06:21   中国经济网

根据这份汇总情况,人身险公司产品开发管理中存在五个方面的主要问题。一是产品报备材料不合规,二是产品设计不合规,三是产品条款表述不合规,四是产品费率厘定、精算假设不合理,五是产品条款设计不公平。

在五大问题下涉及到多个具体问题,例如,在产品设计方面,某险企将一款医疗保险命名为“**医疗基金保险”,个别险企未按产品设计类型分类命名产品名称;某险企将医疗保险设计为万能型,不符合规定。同时,个别万能险产品未按规定进行账户管理、确定结算利率,实际确定的结算利率与账户投资情况无关,不符合规定。

在产品费率厘定、精算假设方面,部分产品预定附加费用率或初始费用为零或明显偏离实际费用水平;个别产品通过调整产品定价发生率或定价过程,使产品统一费率,混淆保险产品与银行存款的区别;同时,个别公司认定为非中短存续期的产品,但其利润测试的退保率假设前5年已超过60%。

在产品条款设计方面,个别长期保险产品条款约定保险公司保留调整风险保费的权利,可以单方调整费率,对消费者不公平;个别产品的理赔要求不合理,例如,疾病保险产品条款中约定被保险人确诊所保疾病后,需生存一定期限后方可获得保险金给付等;部分健康保险产品设置过长的等待期,或通过调整保险金额等方式变相延长等待期,例如,约定180日至1年内确诊所保疾病,给付50%保险金额,变相延长等待期。

“这些问题有的涉及理财型保险,有的涉及保障型保险,有的属于主观规避监管规定,有的属于管理疏漏工作不细致。”上述不愿具名人士表示,在当前强调“保险姓保”且实施严监管的形势下,一些偷换概念、刻意规避监管的行为预计难以侥幸通关。

四大现象值得警惕

除了对部分保险产品在开发设计中的具体问题进行通报,保监会还指出了一些值得关注的问题。这些问题也可能成为保险公司新品申报被“打回”的原因。

具体来看,这四大现象包括产品开发重数量轻质量,重形式轻效果;产品设计与产品特性相违背;产品责任偏离产品属性,以及产品组合销售弱化产品本质。

例如,部分保险公司开发报备多款内容相近、名称相仿的同质化产品,命名为“1号”、“2号”……或“A款”、“B款”……这些产品仅保险期间、缴费方式或某设计参数略有差别,没有形成产品差异化特点;个别保险公司开发报备多种类型产品,但实际销售的产品仅为极少数,产品资源严重浪费,特别是保障类产品仅开发不销售,不利于“保险业姓保”的理念回归。

同时,一些万能型产品条款约定只可以趸交,不允许消费者追加保费,与万能型产品交费灵活的特点相违背;个别险企刻意调整投资连结型产品投资安排,使产品投资收益率在一定时间内为固定值,且在销售宣传时明示或暗示产品为“保证收益”,误导消费者,与投资连结型产品投资风险由消费者自行承担相违背。

此外,部分险企在销售保险产品组合时,强调理财而弱化保障。例如,部分险企在产品销售宣传时,强调“投资组合”、“投资收益”等内容,弱化保险产品的保障功能,误导消费者;一些年金保险产品通过约定在犹豫期后即给付一定比例的年金或生存金,实现快速向消费者返还保费的目的,不符合年金保险的本质,且在产品销售时将生存给付表述为“折扣”、“优惠”,误导消费者。

例如,保监会今年5月份向某寿险公司下发监管函,原因便是该公司的一款年金保险产品设计偏离保险本源,通过生存金返还设计形式,将消费者所交保费大量快速返还,把长期年金保险“长险短做”,实际做成两年期业务,规避保监会中短存续期产品的有关监管规定,扰乱市场秩序。

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