2018年-FCA英国金融行为监管局_general_insurance_value_measures_data_second_information_request_8页_246kb

FCA General Insurance Value Measures Pilot Summary

Scope of the Pilot

The FCA Information Request focuses on General Insurance products and includes the following pilot products:

• Home (Buildings and Contents): Combined policies covering both property structure and contents, including liability risks for injuries within the property. Excludes contents-only and buildings-only policies.
• Home Emergency (stand-alone or add-on): Policies providing household assistance services, falling under class 18 of the 2001 Regulated Activities Order.
• Personal Accident (add-on to motor/home insurance): Add-on policies covering personal injury, excluding medical expenses, healthcare cash plans, travel, and creditor cover.
• Key Cover (add-on to motor insurance): Policies covering loss, theft, or damage of keys, sold as an add-on to motor insurance.

Group policies are not included in the scope of this pilot.

Reporting Requirements

Reporting Period

• The data is required for the year ended 31 August 2017.
• A potential third reporting period for the year ended 31 August 2018 is under consideration.

Reporting Thresholds

Insurers must report data for each pilot product only if both of the following thresholds are met:

Data to be Reported

Insurers must complete the attached spreadsheet proforma and provide the following additional information (not published):

1. Product reviews for pilot products from 1 September 2016 to 31 August 2017.
2. Pricing committee papers and minutes, and other relevant committee minutes and papers related to the pilot.
3. Cost estimates for regular data collection and reporting, separating one-off and ongoing costs.
4. Impact summary of the pilot and data publication on the business, including:
   • Use of published data
   • Changes in products
   • Press or other external inquiries

Guidance for Completing the Proforma

Note 1: Add-on and Stand-alone Sales

• Add-on policies are those with separate cover and premium sold alongside a primary policy or non-insurance product.
• Stand-alone policies are sold independently.
• If a product includes core cover (not an add-on), the data should be reported under the main product (e.g., home).
• Accidental damage is not considered an add-on to home.

Note 2: Distributors and Brands

• List the top 5 distributors/brands by retail premium for each product.
• For insurers using a delegated authority model, confirm this in the response.
• Data for all business should be reported at the firm level, not limited to top 5.

Note 3: Number of Policy Sales

• Includes individual policies sold to UK consumers (renewals and new sales).
• Excludes group policies.

Note 4: Total Retail Premiums (written)

• Based on gross retail premiums charged to the end consumer (net of IPT).
• Excludes mid-term adjustments, cancellations, and other fees (e.g., cancellation fees, change of address fees).

Note 5: Average Premium

• Calculated as: Total Retail Premiums (written) ÷ Number of Policy Sales.

Note 6: Claims Registered

• Refers to claims raised by customers and registered by the insurer.
• Excludes:
  • Enquiries (even if recorded on the system)
  • Claims where the customer decides not to proceed
  • Claims where the insurer advises the loss is not covered or below excess and the customer does not pursue it further
• Includes:
  • Claims that are registered but not subsequently pursued

Note 7: Average Number of Policies in Force

• Calculated as: Average of policies in force at the end of each month during the year.

Note 8: Claims Frequency

• Published in bands.
• Calculated as: Claims Registered ÷ Average Policies in Force.

Note 9: Claims Accepted and Paid Out

• Includes all claims fully or partially accepted and closed at the end of the year.
• Includes claims registered in previous periods that were paid out in the current year.
• Excludes claims still open or under investigation.

Note 10: Claims Rejected

• Includes claims rejected for the following reasons:
  • Claims below the policy excess
  • Fraud walkaways (suspected fraud, not proven)
  • Breach of policy conditions
  • No cover due to exclusions
  • Policy voided
• Excludes:
  • Claims where the customer contacted the wrong insurer
  • Claims where the customer was informed they are not covered (enquiries)
• Includes:
  • Claims registered in previous periods and rejected in the current year

Note 10a: Claims Below the Policy Excess

• A subset of rejected claims.

Note 10b: Fraud Walkaways

• A subset of rejected claims.

Note 11: Claims Acceptance Rate

• Published in bands.
• Calculated as: (Claims Registered - Claims Rejected) ÷ Claims Registered.

Note 12: Total Claims Pay-out Cost

• Includes:
  • Direct pay-outs to beneficiaries
  • Other costs directly benefiting the customer (e.g., repair costs, service costs)
  • Specific claims handling costs (e.g., investigation, assessment)
• Excludes:
  • General claim handling expenses
  • Non-claims costs
  • Regular service elements (e.g., helpline, boiler service)

Note 13: Average Claims Pay-out Cost

• Published in bands.
• Calculated as: Total Claims Pay-out Cost ÷ Number of Claims Accepted and Paid Out.

Note 14: Top 10 Reasons for Claims Rejection

• List the top 10 reasons for claim rejections, with the most common first and least common last.
• If data is available, include the number of rejected claims for each reason in 2016.

Additional Q&A Guidance

• Embedded Cover in Home Policies: If personal accident or home emergency is embedded in a home policy, it should be reported under the home product.
• Data Granularity: Data should be reported at the firm level, not limited to the top 5 distributors/brands.
• Rejected Claims with Supplier Investigation Fees: If the only payment is a supplier investigation fee and the claim is not accepted, it should still be reported as a rejected claim.
• Claims Registered and Accepted/Rejected in Different Periods: Claims accepted or rejected in the current period may relate to claims registered in previous periods.
• Claims Reopened in Subsequent Periods: Any additional pay-outs from reopened claims should be included in the current period.