第8章政府对保险业的监管

– The state insurance department assumes control of insurance companies that they determine to be financially impaired
• All states have guaranty funds that provide for the payment of unpaid claims of insolvent property and casualty insurers • States have guaranty laws and guaranty associations that pay the claims of policyowners of insolvent life and health insurers • The assessment method is the major method used to raise the necessary funds to pay unpaid claims
– A foreign insurer is an out-of-state insurer that is chartered by another state, but licensed to operate in the state
– An alien insurer is an insurer that is chartered by a foreign country, but is licensed to operate in the state
– All states require agents and brokers to be licensed – Insurance laws prohibit a variety of unfair trade practices, such as misrepresentation, twisting, and rebating
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What Areas Are Regulated?
– Each insurer must file an annual report with the state insurance department in the states where it does business
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监管的领域
– 风险资本
• 风险资本 (RBC) 意味着保险公司必须持有一定的资本， 这取决于它们的投资和保险业务。 • RBC影响因素:
– – – – 资产风险 核保风险 利率风险 商业风险
• A comparison of the company’s total adjusted capital to the amount of required risk-based capital determines whether company or regulatory action is required
• Laws generally place a limit on the proportion of assets in a specific asset category, such as real estate
– Many states limit the amount of surplus a participating life insurer can accumulate, rather than pay as dividends
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监管的领域
• 偿付能力监管
– 资产必须足以偿还债务。
• 法定资本 出现在法定资产负债表中的决定其财务状况的资产。
– 法定准备金 – 盈余
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– 肯定了保险并非跨州商业行为
• 东南保险承保人协会 (1944) 一旦超出州界就是跨州 行为。
– 对商业费率厘定组织的合法性进行质疑。
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ቤተ መጻሕፍቲ ባይዱ
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保险监管法的发展历程
• 麦卡伦福古森法案 (1945) 声明由政府对保险业继续 进行监管和征税符合公众利益。
第八章
政府对保险业 的监管
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目录
• 保险监管的原因
• 发展历史 • 监管方法 • 监管领域 • 联邦和州政府的监管 • 保险监管的现状和问题
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• • • • • • • Prior approval law Modified prior approval law File-and-Use law Use-and-File law Flex Rating law State made rates Open Competition
– Many states exempt insurers from filing rates for large commercial accounts – Life insurance rates are not directly regulated by the states
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What Areas Are Regulated?
• Rate regulation takes a variety of forms across states
– Forms of rate regulation for property and casualty insurance include:
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监管的领域
• 保险公司的组织形式和经营资格
– Licensing includes minimum capital and surplus requirements
– A domestic insurer is domiciled in the state
– Federal antitrust laws apply to insurance only to the extent that the insurance industry is not regulated by state law
• e.g., insurers are not exempt from the Sherman Act provisions
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保险监管的原因
• 保证保险公司偿付能力 • 弥补消费者的知识不足 • 确保费率合理 • 使保险可以销售
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发展历史
• 最早的保险公司需要遵守的监管要求很少 • 保罗诉弗吉尼亚案 (1868) 确认了州政府对保险的监 管权利。
– Uniformity of laws – Greater efficiency – More competent regulators
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State versus Federal Regulation
• The three principal methods of regulating insurers are:
– Legislation, through both state and federal laws – Court decisions, e.g., interpreting policy provisions – State insurance departments
• Twisting is the inducement of a policyowner to drop an existing policy and replace it with a new one that provides little or no economic benefit to the client • Rebating is the practice of giving an individual a premium reduction or some other financial advantage not stated in the policy as an inducement to purchase the policy
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What Areas Are Regulated?
• State insurance commissioners have the authority to approve or disapprove new policy forms before the contracts are sold to the public • Sales practices are regulated by the laws concerning the licensing of agents and brokers