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2018年终盘点:互联网保险创新和监管调试中稳步前行
2019-01-12

根据2018年10月份下发的《互联网保险业务监管办法(草稿)》(业界称为“《征求意见稿》”),互联网保险业务是指保险公司、保险中介机构依托互联网和移动通信等技术,通过自营网络平台、第三方网络平台等订立保险合同、提供保险服务的业务。截至2017年末,全国共有117家保险公司经营互联网保险,占保险公司总量的52.7%。

2018年互联网保险业务依然延续了近年来的迅猛发展趋势,互联网与保险进一步融合,人工智能、大数据、区块链等技术加速向保险行业渗透,保险业务的数字化转型正迸发出蓬勃生机。据统计,2018年前三季度,易安保险、众安保险、泰康在线、安心保险四大互联网保险公司,实现原保险保费收入64.64亿元,同比增长133.77%,远高于行业平均增速。回顾2018年,我们看到,互联网保险业务在行业创新和监管调试中稳步前行。

一、金融监管体制改革下的互联网保险监管

年初,保险行业监管格局发生变化。2018年3月召开的十三届全国人大一次会议审议并通过了《国务院机构改革方案》,该方案将中国银行业监督管理委员会和中国保险监督管理委员会的职责整合,组建中国银行保险监督管理委员会,其主要职责是,依照法律法规统一监督管理银行业和保险业,维护银行业和保险业合法、稳健运行,防范和化解金融风险,保护金融消费者合法权益,维护金融稳定。同时,将中国银行业监督管理委员会和中国保险监督管理委员会拟订银行业、保险业重要法律法规草案和审慎监管基本制度的职责划入中国人民银行。3月21日,中国银行保险监督管理委员会举行成立大会。8月,银保监会“三定”方案出炉,新的银保监会将设26个内设职能部门加机关党委,并设置**风险官、**检查官、**律师和**会计师。12月17日,银保监会下辖的36个省(自治区、直辖市、计划单列市)银保监局统一挂牌。

新成立的银保监会在监管理念和重点上有所调整。根据8月29日召开的银行保险监管工作电视电话会议,此次会议提出近期的工作重点中首要的就是继续做好防范化解金融风险各项工作,特别提出要自觉在互联网金融风险整治的框架下,发挥好银行保险监管部门职责,防控处置好互联网金融风险;积极防范、稳妥处置好其他重点领域、重点机构风险,牢牢守住不发生系统性金融风险的底线。

4月25日,中国银行保险监督管理委员会网站还发文提示了互联网保险的三大风险隐患——风险一是“吸睛”产品暗藏误导:有的保险机构为片面追求关注度和销售量,存在宣传内容不规范、网页所载格式条款的内容不一致或显示不全、未明确说明免责条款等问题,涉嫌误导消费者;风险二是在线平台暗藏“搭售”:某些在线平台在其票务、酒店预定页面通过默认勾选的方式销售一些保险产品,未明确列明承保主体或代理销售主体,未完整披露保险产品条款等相关重要信息。风险三是“高息”产品暗藏骗局:一些不法分子利用互联网平台虚构保险产品或保险项目,或承诺高额回报引诱消费者出资,或冒用保险机构名义伪造保单,往往涉嫌非法集资,给消费者造成经济损失。

二、互联网与保险进一步融合,数字化转型加速

2018年互联网头部企业继续加速布局保险业务,监管方也给予了相当的支持。2月24日,保监会批复美团点评实际控制的重庆金诚互诺保险经纪有限公司获得保险中介机构牌照。7月24日,银保监会批复同意了安联财产保险(中国)有限公司的增资方案,增资后北京京东叁佰陆拾度电子商务有限公司持股30%。这意味着京东拿到了一块财险保险牌照。11月2日,京东宣布,获中国银保监会批准,安联财产保险(中国)有限公司获准更名为京东安联财产保险公司,这也是继阿里、腾讯后第三家互联网巨头拿到了保险牌照。此外,百度、小米、美团、滴滴、今日头条、新浪、唯品会也在加速布局保险业务。同样值得注意的是,12月20日,香港保险业监管局向保泰人寿发出首张虚拟保险牌照。这家新型保险公司持有和使用全数码分销渠道,不涉及任何保险中介。

另一方面,保险服务的数字化转型升级也提上了监管方的日程。6月,有消息称,监管部门拟全面推进保险服务标准化制度建设,搭建标准化制度体系框架,《中国保险服务标准体系监管制度框架》已起草完毕,正在业内进行第二次征求意见。框架的总体目标包括推进保险服务数字化转型升级,加快数字保险建设,构建以数据为关键要素的数字保险,推动保险服务供给侧改革,更好服务我国经济社会发展和人民生活改善;框架的制度特征包括“数字化、网络化、智能化导向”的表述。此外,中国保险学会也联合业界成立了“保险智能风控实验室”,将全方位为保险反欺诈提供专业化、智能化的解决方案,利用AI手段解决国内保险风控的痛点,充分发挥大数据、人工智能、云计算等技术优势,为保险业欺诈风险的分析和预警监测提供支持。

三、将互联网保险纳入防范化解重大风险攻坚战,强化监督管理

防控互联网保险业务风险是2018年监管层的主要着力点。1月17日,保监会印发关于《打赢保险业防范化解重大风险攻坚战的总体方案》的通知,《方案》提出关注利用互联网技术推广的、影响客户信息安全的、互联网借贷相关的各类新型保险业务风险和财险公司、人身险公司、保险中介机构与第三方网络平台合作开展保险业务的风险隐患,要求采取有效措施汇总并评估各类互联网保险业务风险,以及非法开展互联网保险业务的风险;提出改进互联网保险监管制度,研究制定互联网创新型保险业务的监管制度。

新成立的银保监会延续了《方案》的部署。除了上述4月25日银保监会发布的《风险提示》外,6月4日,银保监会还发布了《关于2017年度保险业偿付能力监管工作情况的通报》,明确指出在发展互联网保险领域,银保监会将重点展开险企偿付能力真实性核查工作,加大查处力度,对造假公司采取严厉措施;此外,互联网保险产品在网络平台的销售过程中,涉嫌未明确说明免责条款、未完整披露保险产品条款、宣传内容不规范等问题,也将作为2018年金融监管部门整治的险企风险问题之一。同一日,银保监会下发了《关于加强自媒体保险营销宣传行为管理的通知》,要求各保险公司、保险中介机构提高对自媒体保险营销宣传行为管理重要性的认识,建立健全自媒体保险营销宣传行为管理制度,加强从业人员合规教育与职业道德教育。确保营销宣传信息合规准确,完善信息监控和处置机制,加大责任追究力度,落实监管责任。

在对互联网保险的具体监管和执法上,也贯穿了防范风险和从严监管的要求。*典型的是11月,两款“互联网+互助”保险产品被监管约谈,并被叫停。据其中一个产品参与方的披露,被叫停的原因是“涉嫌存在未按照规定使用经备案的保险条款和费率、销售过程中存在误导性宣传、信息披露不充分等问题。”在对互联网保险的执法方面,7月4日,浙江保监局网站上公布了两张有关互联网保险的罚单,剑指虚构部分技术服务费来支付推广费的违法行为等问题。而10月18日,银保监会对6家保险公司开出监管函,互联网保险公司占了其中一半。

四、健全完善互联网保险监管规范体系

互联网保险的稳健发展依赖于专门监管规则体系的建设。2015年,原中国保监会曾印发《互联网保险业务监管暂行办法》,作为互联网保险的基本依据,但根据原规定的施行期,该办法将于2018年10月到期失效。因此,2018年互联网保险监管规范体系建设逐步提速。9月30日,中国银保监会印发《中国银保监会关于继续加强互联网保险监管有关事项的通知》,表示正在加快《互联网保险业务监管暂行办法》的修订工作,在新的规定出台以前,原《暂行办法》继续有效。《通知》既肯定了《暂行办法》3年以来的规制价值,又面对新形势新问题对加强互联网保险监管提出要求。10月中旬,银保监会又对《互联网保险业务监管办法(草稿)》进行征求意见。征求意见稿放宽了保险公司、保险中介机构和保险公估机构经营互联网保险的区域限制;允许银行类保险兼业代理机构在其自营网络平台开展互联网保险业务;针对互联网保险信息披露和宣传方面做出详细规定;对第三方平台的资质、信用程度等方面提出了监管要求。

针对互联网时代保险业务的新特点,今年银保监会还着手制定保险实名登记管理和保险销售行为可回溯管理的有关制度并征求意见。其中《保险实名登记管理办法》的征求意见稿明确,保险实名登记,是指包括第三方网络平台在内的机构及其从业人员在为投保人、被保险人、受益人办理保险业务时,依照本办法要求核对身份证件,并查验和登记实名信息的行为。银保监会建立保险实名查验登记平台,用于保险实名信息查验、登记和保险账户管理。银保监会委托、指导第三方机构承担保险实名查验登记平台的建设和运行管理。对于存在严重违法失信行为的,将其列入联合惩戒对象,实施联合惩戒。如存在使用虚假身份证件、冒用他人名义、提供虚假信息等行为的,将被纳入失信行为记录名单。

根据2017年出台的《保险销售行为可回溯管理暂行办法》,保险公司、保险中介机构开展互联网保险业务,依照中国保监会互联网保险业务监管的有关规定开展可回溯管理。今年7月,银保监会下发《关于规范互联网保险销售行为可回溯管理有关事项的通知(征求意见稿)》,明确规定:“保险机构通过第三方网络平台开展互联网保险销售的,应在第三方网络平台单独设置说明所售产品为保险和投保意愿确认界面,由投保人主动确认后进入保险机构自营平台投保流程。”根据该征求意见稿,互联网保险销售行为可回溯管理涵盖销售界面管理和销售过程记录两项。其中,前者指保险机构应保存销售过程中关键销售界面的内容信息及历史修改信息,建立版本管理机制;后者指保险机构应保存销售过程中客户投保信息、操作平台、操作轨迹、操作时间,以及保险机构收到或传递投保人投保申请的时间。

--本文源自京东数字科技研究院

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