Legal and Regulatory Obligations of Organizations 保險公司的法律及規管責任

Insurers’ Contractual Duties and Statutory Requirements 保險人的合約責任及法定要求

Once an insurer enters into an insurance contract, its obligations towards the insured are governed by the relevant principles of contract law. Under common law, utmost good faith is a mutual duty: the insurer must observe it as well as the insured.

The requirements identified in the 2022 study scope under the Insurance Ordinance (Cap. 41) include insurer authorisation, capital, solvency margin and adequate reinsurance. Controllers, directors, key persons in control functions and appointed actuaries must also meet fit and proper requirements.

These requirements support insurers’ financial and operational soundness and their ability to continue meeting commitments to policyholders. They therefore underpin customer service in its broader sense. [IA study notes, sections 4.4(a)–(b)](https://www.ia.org.hk/en/supervision/reg_ins_intermediaries/files/P2_2022_Study_Notes_Eng_final.pdf)

The Insurers’ Code and Statutory Regulation of Intermediaries 承保商專業守則及中介人法定監管

The Hong Kong Federation of Insurers introduced the Code of Conduct for Insurers to promote good insurance practice and help consumers understand expected service standards. Its scope requires three conditions together: insurance effected in Hong Kong, a policyholder resident in Hong Kong, and an individual taking out insurance in a private capacity.

The Code addresses advising and selling practices, claims handling, management of insurance agents, staff management, misconduct by insurers, and handling enquiries, complaints and disputes. A company buying commercial insurance in Hong Kong does not thereby fall within the stated scope for individuals insuring privately.

Part X of the Insurance Ordinance provides a statutory basis for regulating insurance intermediaries. It covers the definitions, roles and responsibilities of licensed insurance agents and licensed insurance brokers, with prescribed penalties for illegally claiming either licensed status.

The Insurance Authority took over regulation of insurers from the former Office of the Commissioner of Insurance on 26 June 2017. It took over regulation of insurance intermediaries on 23 September 2019 from three self-regulatory organisations: the Insurance Agents Registration Board, the Hong Kong Confederation of Insurance Brokers and the Professional Insurance Brokers Association. [IA study notes, sections 4.4(c)–(d)](https://www.ia.org.hk/en/supervision/reg_ins_intermediaries/files/P2_2022_Study_Notes_Eng_final.pdf)

IA Codes, Guidelines and Broker Company Rules 保監局守則、指引及經紀公司規則

Section 133 of the Insurance Ordinance allows the IA to publish non-statutory codes and guidelines concerning its functions or the operation of the Ordinance, providing practical help with compliance. Non-compliance does not by itself make a person liable to judicial or other proceedings. However, the codes and guidelines are admissible in court proceedings under the Ordinance, and the IA considers them when exercising its powers, including disciplinary action where applicable.

The Code of Conduct for Licensed Insurance Agents, issued by the IA under section 95, has three parts: introduction, interpretation and general principles. The general-principles part has nine sections: eight address honesty and integrity; acting fairly and in the client’s best interests; care, skill and diligence; competence to advise; disclosure of information; suitability of advice; conflicts of interest; and client assets. The ninth covers corporate governance and controls and procedures.

Licensed insurance broker companies must comply with the Insurance (Financial and Other Requirements for Licensed Insurance Broker Companies) Rules. The five areas identified here are share capital and net assets, professional indemnity insurance, client accounts, proper books and accounts, and accounting disclosure.

The Code of Conduct for Licensed Insurance Brokers addresses professional conduct in brokerage business. Its general principles and associated standards and practices establish the minimum professional standards expected of licensed insurance brokers when carrying on regulated activities. [IA study notes, sections 4.4(e)–(h)](https://www.ia.org.hk/en/supervision/reg_ins_intermediaries/files/P2_2022_Study_Notes_Eng_final.pdf)

Other Relevant Legislation and Ethical Matters 其他相關法例及道德事宜

Customer service also involves legislation on personal data and equal opportunities. This section identifies the Personal Data (Privacy) Ordinance (Cap. 486), the Sex Discrimination Ordinance (Cap. 480), the Disability Discrimination Ordinance (Cap. 487), the Family Status Discrimination Ordinance (Cap. 527) and the Race Discrimination Ordinance (Cap. 602).

The two Ordinances identified here as connected with money laundering are the Drug Trafficking (Recovery of Proceeds) Ordinance (Cap. 405) and the Organized and Serious Crimes Ordinance (Cap. 455). The United Nations (Anti-Terrorism Measures) Ordinance (Cap. 575) is also relevant; candidates should distinguish the matters addressed by these three Ordinances.

The Prevention of Bribery Ordinance (Cap. 201) and prevention of insurance fraud also belong within this section. These legal and ethical matters may affect customer service directly or indirectly, so fulfilling policy promises is only part of an insurer’s responsibilities. [IA study notes, section 4.4(i)](https://www.ia.org.hk/en/supervision/reg_ins_intermediaries/files/P2_2022_Study_Notes_Eng_final.pdf)