Administrative Measures on Handling Insurance Consumption Complains

Administrative Measures on Handling Insurance Consumption Complains

Order of the China Insurance Regulatory Commission [2013] No. 8

July 1, 2013

The Administrative Measures on Handling Insurance Consumption Complains, reviewed and adopted by the Chairman's executive meeting of the China Insurance Regulation Commission on June 5, 2013, are now promulgated and shall enter into force as of November 1, 2013.

Chairman Xiang Junbo

Administrative Measures on Handling Insurance Consumption Complains

Chapter I General Provisions

Article 1 These Measures are formulated in accordance with such laws as the Insurance Law of the People's Republic of China and other administrative regulations, with a view to regularizing insurance consumption complaints handling and safeguarding the lawful rights and interests of insurance consumers.

Article 2 The term "insurance consumption complaints" mentioned in these Measures includes the insurance consumption complaints filed by insurance consumers with insurance institutions and insurance intermediary institutions and those filed with the China Insurance Regulatory Commission (the CIRC) and any of its detached offices.
The expression "insurance consumers file any insurance consumption complaints with insurance institutions or insurance intermediary institutions" refers to the situation that insurance consumers have any dispute with insurance institutions, insurance intermediary institutions, or insurance practitioners during insurance consumption activities and reflect the related information to the insurance institutions or insurance intermediary institutions for the purpose of settling the dispute.
The expression "insurance consumers file any insurance consumption complaints with the China Insurance Regulatory Commission or any of its detached offices" refers to the situation that insurance consumers think that their lawful rights and interests are damaged in insurance consumption activities due to the violation of the related insurance regulation laws, administrative regulation and the requirements of the China Insurance Regulatory Commission by insurance institutions, insurance intermediary institutions, or any insurance practitioners, and they report the related information to the China Insurance Regulatory Commission and any of its detached office to apply for performing statutory regulatory duties.

Article 3 Insurance consumption complaint handling shall uphold the principle of abiding by laws, fairness, impartiality and providing convenience for the people, so as to improve work efficiency and safeguard the lawful rights and interests of consumers as best as practical.

Article 4 The insurance consumer protection department of the China Insurance Regulatory Commission is the administrative department for insurance consumption complaint handling nationwide and is responsible for the supervision and administration of insurance consumption complaint handling across China.
The detached offices of the China Insurance Regulatory Commission shall specify the administrative department regarding insurance consumption complaint handling for the supervision and administration of insurance consumption complaint handling within its jurisdiction.

Article 5 Insurance institutions and insurance intermediary institutions shall set up or designate their departments, posts and working personnel to be responsible for insurance consumption complaint handling, and the statistical analysis and administration of their insurance consumption complaint handling.
Insurance companies and their branches at provincial level, professional insurance agency companies, insurance brokerage companies, and insurance assessment institutions shall designate their senior management personnel supervising insurance consumption complaint handling to be the person responsible for their insurance consumption complaint handling.

Article 6 Insurance companies, professional insurance agency companies, insurance brokerage companies and insurance assessment companies shall strengthen their administration, guidance, assessment and coordination of the insurance consumption complaint handling of their branches, and assist their branches in properly handling various insurance consumption complaints.

Article 7 Insurance associations shall set up an insurance consumption complaint handling mechanism and actively coordinate and urge member insurance institutions and insurance intermediary institutions to handle insurance consumption complaints in time.

Article 8 The detached offices of the China Insurance Regulatory Commission shall provide guidance for setting up and improving the insurance dispute handling and settlement mechanism within their respective mechanism and supervise their operation.
Insurance associations shall strengthen their self-regulation and coordination and urge member insurance institutions and insurance intermediary institutions to settle insurance consumption complaint handling by means of consultation and mediation and properly carry out the construction and administration of insurance dispute mediation institutions, so as to promote the normal operation of the insurance dispute mediation and handling mechanism.
Insurance companies, professional insurance agency companies, insurance brokerage companies, and insurance assessment institutions shall guide and support their branches to participate in the local insurance dispute mediation and handling mechanism, and consult with insurance consumers with regard to settling insurance consumption disputes.
The detailed measures for the insurance dispute mediation and handling mechanism shall be otherwise formulated by the China Insurance Regulatory Commission.

Chapter II Duties and Job Division

Article 9 Insurance institutions shall be responsible for handling the following complaints lodged by insurance consumers:
1. Disputes with the related entity due to the provisions of the insurance contract;
2. Disputes with the related entity due to sale of insurance, underwriting, discharge of insurance, preservation, compensation, etc; and
3. Disputes with the related entity due to any other insurance consumption activities.

Article 10 Insurance intermediary institutions shall be responsible for handling the disputes between insurance consumers and the related entity due to insurance intermediary services.
Where insurance consumers file any insurance consumption complaints with insurance institutions, the insurance intermediary institutions which provide such insurance consumers with insurance intermediary services may assist them in reporting the related information or provide them with related facilitating conditions, to promote the smooth settlement of the insurance consumption complaints.

Article 11 The China Insurance Regulatory Commission shall handle the following complaints lodged by insurance consumers:
1. Insurance companies violate the related insurance regulatory laws, administrative regulations and the requirements of the China Insurance Regulatory Commission, which damages the lawful rights and interests of insurance consumers and which shall be handled by the China Insurance Regulatory Commission in accordance with law;
2. Any insurance practitioner violates the related insurance regulatory laws, administrative regulations and the requirements of the China Insurance Regulatory Commission, which damages the lawful rights and interests of insurance consumers and which shall be handled by the China Insurance Regulatory Commission in accordance with law; and
3. Any other circumstances which shall be handled by the China Insurance Regulatory Commission in accordance with law.

Article 12 Any detached office of the China Insurance Regulatory Commission shall handle the following complaints lodged by insurance consumers:
1. Any branch of insurance companies or insurance intermediary institution within the jurisdiction violates the related insurance regulatory laws, administrative regulations and the requirements of the China Insurance Regulatory Commission, which damages the lawful rights and interests of insurance consumers and which shall be handled by the local detached office of the China Insurance Regulatory Commission in accordance with law;
2. Any employee practitioner within the jurisdiction violates the related insurance regulatory laws, administrative regulations and the requirements of the China Insurance Regulatory Commission, which damages the lawful rights and interests of insurance consumers and which shall be handled by the local detached office of the China Insurance Regulatory Commission in accordance with law; and
3. Any other circumstances which shall be handled by the local detached office of the China Insurance Regulatory Commission in accordance with law.

Chapter III Insurance Consumption Complaints Handling

Section 1 Lodging Insurance Consumption Complaints

Article 13 With regard to lodging any insurance consumption complaints, insurance consumers may adopt such means as post, fax, email, telephone, face to face talk, etc.
Where insurance consumption complaints are lodged by such means as post, fax, and email, insurance consumers shall send the complaint materials to the address, fax number, or email designated by the complaint handling entity.
Where insurance consumption complaints are lodged by telephone, insurance consumers shall dial the telephone number designated by the complaint handling entity.
Where insurance consumption complaints are lodged by face to face talk, insurance consumers shall lodge such complaints at the reception site designated by the complaint handling entity. If no less than 5 insurance consumers propose to jointly lodge insurance consumption complaints by face to face talk, the consumers shall elect one to two representatives.

Article 14 Insurance consumption complaints shall be lodged by the related insurance consumers and the following materials shall be provided at the same time:
1.
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