Section 1 Insurance Consumer Complaints

Thirteenth insurance consumers can complain about insurance consumption by letter, fax, e-mail, telephone and interview.

If complaints about insurance consumption are made by mail, fax or e-mail, the insurance consumer shall send the complaint materials to the mailing address, fax number and e-mail address designated by the complaint handling unit.

If a complaint about insurance consumption is made by telephone, the insurance consumer shall call the telephone number designated by the complaint handling unit.

If an insurance consumer complains by interview, it shall be conducted at the reception place designated by the complaint handling unit. If more than 5 insurance consumers intend to complain about insurance consumption through interviews, they shall elect 1 to 2 representatives.

Fourteenth insurance consumer complaints by the insurance consumer himself, and provide the following materials:

(1) Basic information of the complainant, including: citizen's name, valid certificate number, contact telephone number, contact address and postal code; The name, domicile and postal code of the legal person or other organization, and the name and position of the legal representative or principal responsible person.

(2) The basic information of the respondent, including: the name of the insurance institution or insurance intermediary institution complained of; The relevant information of the complained insurance practitioners and the names of their insurance institutions or insurance intermediaries.

(three) the complaint request, the main facts and reasons, and the relevant facts.

Article 15 If it is really difficult for an insurance consumer to lodge a complaint about insurance consumption on his own, he may entrust others to lodge it on his behalf, but he shall submit the complaint materials, the original power of attorney and the identity certificate of the trustee as stipulated in Article 14 of these Measures to the complaint handling unit. The power of attorney shall specify the entrusted matters, authority and time limit, and shall be signed by the insurance consumer himself.

Article 16 If an insurance consumer's complaint is submitted by e-mail, it can also submit written materials; The complaint handling staff may also ask the complainant to provide relevant certification materials as appropriate.

If an insurance consumer complains by interview, the written materials specified in Article 14 of these Measures may be submitted at the same time, or the relevant complaint materials form may be filled in. If it is really difficult for the complainant to write, the complaint handling staff can record the basic information, complaint request, main facts and reasons of the complainant and the respondent, and the complainant shall sign for confirmation. The complaint handling staff may also ask the complainant to provide relevant certification materials as appropriate.

Where an insurance consumer complaint is made by telephone, the complaint handling personnel shall record the basic information, complaint request, main facts and reasons of the complainant and the respondent, and may require the complainant to provide relevant certification materials as appropriate.

The written materials submitted by the complainant shall be signed by the complainant. Where a legal person or other organization makes a complaint about insurance consumption, the complaint materials shall be stamped with the seal of the unit.

Article 17 The administrative department for handling insurance consumer complaints shall register the complaints accepted by insurance consumers. If the complaint materials are incomplete, the complainant shall be notified to make corrections within 5 working days from the date of receiving the materials.

If an insurance consumer complains about insurance consumption to an insurance institution or insurance intermediary, the insurance institution or insurance intermediary shall not require the complainant to supplement the materials that he has mastered or can obtain through relevant information files.

Article 18 Insurance consumers shall make complaints about insurance consumption objectively and truthfully, and be responsible for the authenticity of the materials they provide. Do not provide false information or fabricate or distort facts, and do not falsely accuse or frame others.

Insurance consumers shall abide by laws, administrative regulations and relevant provisions of the state in the process of complaints about insurance consumption, and maintain public order and the office order of complaint handling units.

Section 2 Acceptance of Insurance Consumption Complaints

Article 19 The administrative department for handling complaints from insurance consumers is the working body of the unit that accepts complaints from insurance consumers.

Article 20 After receiving the complete complaint materials, the administrative department that accepts the complaints of insurance consumers shall promptly review them and deal with them according to the following circumstances:

(a) in accordance with the provisions of these measures, accept the complaints of insurance consumers handled by the unit;

(two) the provisions of the insurance consumer complaints, but do not belong to the unit to deal with, inadmissible, can be handed over to the relevant units;

(3) Complaints from insurance consumers that are not provided for in these Measures but should be handled by other departments of the unit shall be transferred to relevant departments for handling in accordance with relevant regulations;

(four) complaints from insurance consumers that do not belong to these provisions and are not handled by other departments of the unit shall not be accepted;

(five) one of the circumstances stipulated in the first paragraph of Article 21 of these Measures shall not be accepted.

Twenty-first insurance consumer complaints in any of the following circumstances, the complaint handling management department will not accept:

(1) The complaint is not made by the insurance consumer himself or the insurance consumer's trustee;

(two) the unit has accepted the complaint, and the insurance consumer has no new facts and reasons to file the same complaint again within the processing period;

(three) the unit has made a decision on handling the complaint, and the insurance consumer has no new facts and reasons to make the same complaint again.

If an insurance consumer makes the same complaint again within the processing period, but there are new facts and reasons to be verified, the complaint handling management department may combine them, and the processing period shall be recalculated from the date of receiving the new complaint materials.

Article 22 The administrative department handling complaints from insurance consumers shall inform the complainant whether to accept them within 10 working days from the date of receiving the complete complaint materials, and explain the reasons for not accepting them.

Section 3 Decision on Handling Complaints from Insurance Consumers

Article 23 Insurance institutions and insurance intermediaries shall promptly organize investigation and verification of the complaints accepted by insurance consumers, and make the following decisions according to the different situations of complaints:

(1) Performing obligations in accordance with laws, administrative regulations, relevant state regulations and insurance contracts;

(two) does not comply with laws, administrative regulations, relevant state regulations and insurance contracts, the complainant shall do a good job of explanation;

(3) If there is no clear stipulation in laws, administrative regulations and relevant provisions of the state, and the insurance contract is not clearly stipulated, the complainant's opinions shall be solicited in accordance with the principle of fairness and reasonableness;

(4) If the insurance consumer's complaint is not filed by the insurance consumer himself or the insurance consumer's client, the handling of the insurance consumer's complaint shall be terminated and the complainant shall be informed;

(five) before the decision is made, if the complainant withdraws the insurance consumption complaint, the handling of the insurance consumption complaint shall be terminated and the complainant shall be informed.

Article 24 After accepting complaints about insurance consumption, insurance institutions and insurance intermediaries shall make a decision on handling them within the following time limits:

(a) the complaint of an insurance consumer with clear facts and simple disputes shall be handled within 10 working days from the date of acceptance;

(2) Complaints about insurance consumption other than those specified in Item (1) shall be decided within 30 days from the date of acceptance. If the situation is complicated, with the approval of the person in charge of handling the complaints of insurance consumers, the processing period may be extended, but the extension period shall not exceed 30 days, and the complainant shall be informed of the reasons for extending the period.

Article 25 Within 5 working days from the date of decision, insurance institutions and insurance intermediaries shall inform the complainant. The contents of the notice shall include:

(1) Whether the complaint request complies with laws, administrative regulations, relevant state regulations and insurance contracts;

(2) Handling opinions;

(3) If the complainant disagrees with the decision, he may apply for verification in accordance with the provisions of Article 26 of these Measures, or settle it through insurance dispute mediation mechanism or litigation or arbitration.

Article 26 If a complainant refuses to accept the handling decisions of an insurance company branch, an insurance agency branch, an insurance brokerage company branch or an insurance assessment institution branch, he may, within 30 days from the date of receiving the handling decisions, apply in writing to a higher-level institution for verification.

The verification institution shall verify the handling process, handling time limit and handling results of insurance consumer complaints, and make a verification decision within 30 days from the date of receiving the verification application. Within 5 working days from the date of making the verification decision, the verification institution shall inform the complainant.

Twenty-seventh China CIRC and its dispatched offices shall promptly organize investigation and verification of the complaints accepted by insurance consumers, and make a decision within 60 days from the date of accepting the complaints; If the situation is complicated, the handling period may be extended with the approval of the person in charge of the unit, but the extension period shall not exceed 30 days, and the complainant shall be informed of the reasons for extending the period. Where laws, administrative regulations and rules provide otherwise, such provisions shall prevail.

If the complainant withdraws the complaint about insurance consumption before making the decision, or if the China Insurance Regulatory Commission and its dispatched offices find that the complaint about insurance consumption is not made by the insurance consumer himself or the insurance consumer's client, it shall terminate the handling of the complaint about insurance consumption and inform the complainant. According to the relevant regulations, if it is handled by other departments of the unit, it shall be transferred to the relevant departments for handling.

Article 28 Within 5 working days from the date of decision, China CIRC and its dispatched offices shall inform the complainant. The contents of the notice shall include:

(a) whether the respondent violates or is suspected of violating laws, administrative regulations and the provisions of the China Insurance Regulatory Commission on insurance supervision;

(2) Handling opinions;

(three) if the complainant has any objection to the decision, he may apply for verification in accordance with the provisions of Article 29 of these Measures.

Article 29 If a complainant refuses to accept the decision on handling insurance consumption complaints made by the dispatched office of the China Insurance Regulatory Commission, he may, within 30 days from the date of receiving the decision, apply in writing to the China Insurance Regulatory Commission for verification.

China CIRC shall verify the handling process, time limit and results of insurance consumer complaints, and make a verification decision within 30 days from the date of receiving the verification application. Within 5 working days from the date of making the verification decision, China CIRC shall inform the complainant.

Section 4 Insurance Consumer Complaint Handling System

Article 30 Insurance institutions and insurance intermediaries shall publish the telephone number, fax number, mailing address, reception address and e-mail address of their insurance consumers' complaints, and display the complaint handling procedures of insurance consumers on official websites and business premises.

The China Insurance Regulatory Commission and its dispatched offices shall establish and improve the insurance consumer complaint hotline, publish the telephone number, fax number, mailing address, reception address and e-mail address of insurance consumer complaints, and display the procedures for handling insurance consumer complaints on official websites and offices.

Article 31 Insurance institutions, insurance intermediaries, the China Insurance Regulatory Commission and its dispatched offices shall establish an insurance consumer complaint registration system and an insurance consumer complaint file management system, and regularly collect complaint data for analysis and research.

Article 32 Insurance institutions, insurance intermediaries, China CIRC and its dispatched offices shall improve their own insurance consumer complaint handling system, complaint evaluation system and accountability system.

Article 33 Insurance institutions, insurance intermediaries, China Insurance Regulatory Commission and its dispatched offices shall, in accordance with the relevant provisions of the state, formulate emergency response plans for major and group insurance consumer complaints, and do a good job in the prevention, reporting and emergency response of major and group insurance consumer complaints.

Insurance institutions, insurance intermediaries and the dispatched offices of the China Insurance Regulatory Commission shall, in accordance with the relevant provisions of the China Insurance Regulatory Commission, report complaints about insurance consumption of five or more people in groups or with significant influence.

Article 34 The staff responsible for handling complaints about insurance consumption shall abide by the following provisions:

(a) adhere to the principle of seeking truth from facts, act in accordance with the law, and shall not prevaricate, perfunctory or delay;

(two) listen to the facts and reasons of the complainant comprehensively and carefully, and handle them properly to avoid intensifying contradictions;

(3) If he has a direct interest in the complaint of an insurance consumer or the complainant, he shall withdraw;

(4) Comply with relevant confidentiality provisions.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.