Two new rules for the insurance industry came into effect on February 1.
In addition to the recent frequent advertisements of old critical illness insurance products in the circle of friends, which always remind the implementation of the new regulation of critical illness insurance on February 1, Internet insurance also ushered in the new regulation of supervision on the same day.
New rules for Internet insurance market
The “measures for the supervision of Internet insurance business” (hereinafter referred to as the “measures”) issued by the CIRC defines “Internet insurance business”, that is, “insurance business activities in which insurance institutions conclude insurance contracts and provide insurance services relying on the Internet.”
According to the measures, the insurance business that meets the following three conditions at the same time is the Internet insurance business: first, insurance institutions sell insurance products or provide insurance brokerage services through the Internet and self-service terminal equipment; second, consumers can independently understand the product information through the sales page of the self operated network platform of insurance institutions; third, consumers can independently complete the insurance behavior.
Generally speaking, the measures emphasize that institutions and personnel are licensed. According to the measures, Internet insurance business should be carried out by insurance institutions established according to law, and other institutions and individuals are not allowed to carry out Internet insurance business. An insurance institution shall not carry out Internet insurance business beyond the business scope specified in its license (record form).
It is worth noting that, in order to effectively implement the principle of licensed operation, the measures has made a strict and clear definition of self operated network platform: self operated network platform refers to the network platform established by insurance institutions in accordance with the law to operate Internet insurance business independently and enjoy complete data rights. Only the network platform set up by the head office of an insurance institution is a self-supporting network platform. The network platform set up by branches of an insurance institution and non insurance institutions with equity, personnel and other related relations with an insurance institution is not a self-supporting network platform and shall not operate Internet insurance business.
According to the research report released by Bank of China Securities, the measures emphasize licensed operation, standardize the Internet insurance business environment, and benefit the two types of companies. Firstly, the licensed Internet insurance sales platform benefits from the early channel layout, license value and traffic advantages; secondly, the traditional insurance companies with online and offline integration development are expected to broaden the Internet insurance field with the help of the original brand effect and offline channel resources.
It is worth noting that Articles 52 and 58 of the Measures stipulate in principle the insurance products and business areas sold through the Internet. The CIRC will separately stipulate the insurance coverage and relevant conditions for insurance institutions to sell insurance products through the Internet according to the development stage of Internet insurance business and the service guarantee needs of different insurance products.
Wang Min, executive deputy general manager and Secretary of the board of directors of Zhongan online (06060. HK), the first Internet insurance company in China, said earlier that the measures not only set a rigid bottom line, but also set a flexible boundary and reserved sufficient space for development. I believe the introduction of the measures is of great significance to the healthy development of the whole industry and the upgrading and innovation of global insurance industry supervision.
The old version of critical illness insurance products all stopped selling
According to the “Specification for the use of disease definition of major disease insurance (revised version in 2020)” issued by China Insurance Industry Association and China Medical Association (hereinafter referred to as the new specification), from February 1, 2021, major disease insurance contracts signed mainly for adults (18 years old and above) shall comply with the new specification, and all companies shall not continue to sell major disease insurance contracts based on the old specification Serious illness insurance products.
On the basis of the original definition of 25 kinds of serious diseases, the new standard added three kinds of severe diseases, including severe chronic respiratory failure, severe Crohn’s disease and severe ulcerative colitis, and improved and expanded them to 28 kinds of severe diseases. At the same time, it scientifically graded three kinds of core serious diseases, including malignant tumor, acute myocardial infarction and stroke sequelae, and added the corresponding definitions of three kinds of mild diseases And expanded the scope of protection.
At the same time, according to the latest medical progress, the new standard also expands the coverage of eight diseases, including major organ transplantation, coronary artery bypass grafting, heart valve surgery and aortic surgery, and improves and optimizes the definition of seven diseases, including severe chronic renal failure.
As for the upper limit of compensation proportion for mild diseases, the upper limit of insurance amount proportion for three kinds of mild diseases is 30%. If an insurance company adds mild diseases beyond the new standard in its major disease insurance products, the corresponding insurance amount shall be reasonably set by the insurance company itself.
For thyroid cancer, which is more concerned by the outside world, the new standard does not exclude it, but classifies it according to the severity of the disease, and pays for it according to the severity of the disease. For some early-stage malignant tumors that were excluded from compensation in the old standard, the new standard “malignant tumor – mild” was also included in this time according to the above classification principle, such as skin malignant tumors without lymph node and distant metastasis other than melanoma, and prostate cancer with TNM stage of T1N0M0. From this point of view, the protection of consumers is more comprehensive.