V. Life Insurance Procedures 人壽保險程序

A life insurer is led by its board and senior management, with departments sharing the work of a policy's life from sale, underwriting and issue to servicing and claims. Actual structures differ between companies, but candidates must know who does what, especially how the agency, underwriting, policy service, claims and actuarial functions differ.

Typical Company Operational Structure

The application stage runs from completing the application form and paying the first premium to the policy taking effect and the cooling-off period ending. Regulatory requirements such as financial needs analysis, benefit illustrations and important facts statements all aim to ensure that clients buy suitable long term insurance with full understanding.

Application Procedure · Receipts and Policy Effectiveness · Client Service - Policies and Standards · Cooling-Off Period · Policy Replacement · Benefit Illustrations for Long Term Insurance Policies · Distributions of Policy Dividends · Guideline on Underwriting Long Term Insurance Business (Other Than Class C Business) (GL16) · Guideline on Financial Needs Analysis (GL30) · Important Facts Statement for Mainland Policyholder · Guideline on Offering of Gifts (GL25)

Underwriting is the process by which an insurer assesses a life's physical, lifestyle, financial and moral risk factors, then decides whether and on what terms to accept it. A sub-standard life may still be accepted through measures such as an extra premium, a rated-up age, a lien or an exclusion, chosen to fit the pattern of the extra risk.

Underwriting Factors · Medical Reports · Sub-Standard Life and Underwriting Measures

Policy delivery is the step after underwriting when the policy reaches the policy holder, and it gives the intermediary the chance to check details, explain the terms and point out the cooling-off right. The cooling-off period is generally 21 calendar days immediately following delivery of the policy or a cooling-off notice, whichever is earlier.

Policy Delivery

After a long term policy is issued, the policyholder may apply to change it in line with its terms, but the change needs the insurer's agreement and formal recording, usually by endorsement or a revised policy schedule. Changes that increase the insurer's risk generally require evidence of insurability, and those affecting an irrevocable beneficiary's or assignee's rights generally require that party's prior consent.

Policy Changes

Maturity claims, death claims and surrenders all lead to payment under a policy, so the insurer must first verify that the policy is valid, the event has occurred and the payee is entitled, then adjust the amount under the policy terms. Each has a different trigger, set of documents and payee, and candidates must be able to tell them apart.

Maturity Claims · Death Claims · Surrenders