2017年-FCA英国金融行为监管局_general_insurance_value_measures_data_information_request_6页_226kb

FCA Information Request – General Insurance Value Measures Pilot Summary

Scope

The FCA pilot focuses on general insurance products in the UK, specifically targeting the following categories:

• Home (buildings and contents): Insurance covering damage or loss to the structure and contents of domestic properties, including liabilities to third parties arising from injuries within the property.
• Home emergency (stand-alone or add-on to home insurance): Insurance for household assistance, classified under class 18 of the 2001 Regulated Activities Order.
• Personal accident (add-on to motor or home insurance): Insurance for personal injury, not including medical expenses, healthcare cash plans, travel, or creditor cover.
• Key cover (add-on to motor insurance): Insurance for lost, stolen, or broken keys.

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

Reporting Responsibility

• Insurers are responsible for reporting data on the products they underwrite, including those under delegated underwriting authority arrangements.
• Lloyd's managing agents are responsible for reporting on products managed by Lloyd's syndicates.

Reporting Period

• The first reporting period is the year ended 31 August 2016.
• A second reporting period is expected for the year ended 31 August 2017.

Reporting Thresholds

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

If both thresholds are met, the insurer must complete the relevant rows in the attached spreadsheet.

Additional Information to be Provided

In addition to the spreadsheet, the following data must be submitted (not published):

1. Product reviews for the pilot products from 1 January 2015 to 31 August 2016.
2. Detailed management accounts covering the pilot products for the years 2014, 2015, and year to date 2016, including claims management.
3. Details of product design changes since 1 January 2015, including:
   • Price changes
   • Changes to terms and conditions
   • Changes in sales approach or distribution
   • Minutes from pricing and internal committees, along with relevant papers.

Notes on Completing the Proforma

Note 1: Add-on and Stand-alone Sales

• Add-on refers to a general insurance policy bought alongside or in connection with a primary product.
• Only report add-ons as separate policies.
• Stand-alone is a policy not sold with another policy.
• If a product is an optional extra or part of standard cover within a home policy, its data should be included in the home reporting.

Note 2: Distributors and Brands

• List the largest 5 distributors/brands (by retail premiums) for each reporting row.

Note 3: Number of Policy Sales

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

Note 4: Total Retail Premiums (written)

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

Note 5: Average Premium

• Calculated by dividing total retail premiums (written) by number of policy sales.

Note 6: Number of Claims Registered

• Counts claims reported by retail customers and registered by the insurer.
• Single claim if an event covers multiple components.
• Not counted if a customer reports an event but does not wish to make a claim.
• Not counted if the customer is informed the loss is not covered or the claim is below the excess and decides not to proceed.

Note 7: Average Number of Policies in Force

• Calculated by averaging the number of policies in force at the end of each month during the reporting year.

Note 8: Claims Frequency

• Calculated by dividing number of claims registered by average policies in force.
• Data will be published in bands.

Note 9: Number of Claims Accepted and Closed

• Includes claims where payment has been made and the claim is closed at year-end.
• Partially accepted claims where all or part is paid and the claim is closed should be included.
• Reopened claims in subsequent periods should not be included in this field.

Note 10: Number of Claims Rejected

• Includes claims declined for fraud (excluding proven fraud), breach of policy conditions, or no cover.
• Proven fraud is defined by the Insurance Fraud Register.
• Partial rejections during the year are not included, unless the remaining elements are rejected in the following year.
• Claims not registered, or where the customer decides not to pursue, are excluded.

Note 11: Claims Acceptance Rate

• Calculated by:
  $$
  \frac{\text{Number of claims registered} - \text{Number of claims rejected}}{\text{Number of claims registered}}
  $$
• Data will be published in bands.

Note 12: Total Claims Pay-out Cost

• Includes:
  • Direct pay-outs to policy beneficiaries
  • Other costs directly benefiting the customer (e.g., repair costs for home insurance)
  • Specific claims handling costs (e.g., investigation, loss assessment)
  • Costs of regular service elements (e.g., helpline, boiler service) allocated to customers using the service.
• Excludes:
  • General claim handling expenses
  • Non-claims costs
• Scenarios:
  • Pay-outs from previous years that are completed in the current period should be included.
  • Additional pay-outs from reopened claims should be included.
  • Recoveries from other firms should be netted off.

Note 13: Average Claims Pay-out

• Calculated by dividing total claims pay-out cost by number of claims accepted and closed.
• Data will be published in bands.