Company Operation 公司運作

Typical Company Operational Structure 典型公司運作結構

A life insurer is normally directed by its board and run by a chief executive and senior management, with departments beneath them. There is no uniform set of department names or divisions. A smaller company may combine some departments or outsource certain work, so in the exam focus on the function rather than the department name.

Sales and new business functions: the agency or marketing department recruits, trains and manages agents and drives sales and product promotion. The new business department receives and checks applications, while the underwriting department assesses the risk and decides whether to accept on standard terms, accept with conditions or an extra premium, postpone or decline. An agent only submits the application and related information, has no authority to decide acceptance, and should not promise the client an underwriting result. Once an application is accepted, the policy is issued.

After-sales functions: the policy service (or customer service) department handles routine matters on policies in force, such as changes of correspondence address or beneficiary, premium collection and reminders, policy loans, surrenders, recording assignments and reinstatement requests. Reinstatement usually requires evidence of insurability, so that evidence is normally passed to underwriting for assessment. The claims department checks that the policy is in force, the documents are complete and the event is covered, and whether there was any non-disclosure or misrepresentation at application, before deciding the claim and arranging payment.

Support and control functions: the actuarial department handles product pricing, calculates policy reserves, assesses solvency and makes dividend recommendations, and an insurer carrying on long term business must appoint an appointed actuary. The investment department manages the funds built up from premiums and works with the actuarial department to match assets with long-term liabilities. The finance department handles accounting, financial reporting and regulatory returns. The legal and compliance department deals with policy wording, legal matters and regulatory compliance, while internal audit independently reviews internal controls, and the IT and human resources departments provide support. Under the Insurance Ordinance (Cap. 41), risk management, financial control, compliance, internal audit, actuarial and intermediary management are control functions, and an authorized insurer's appointment of key persons in these functions requires the Insurance Authority's approval.