Guidance · FSA · 5 Jun 2012
Issued by Japanese financial regulators in January 2012, this manual establishes the framework and standards for inspecting insurance companies to ensure business soundness and customer protection. It mandates a risk-focused, forward-looking inspection approach that emphasizes in-depth analysis of root causes and dynamic improvement efforts rather than mechanical compliance. The document provides detailed checklists for governance, legal compliance, sales management, and various risk areas to guide inspectors in evaluating internal control systems and corporate responsibility.
(Provisional translation)
*This translation is provisionally prepared and subject to change without notice. Insurance Inspection Manual (Inspection Manual for Insurance Companies) January 2012
Insurance Inspection Manual
Table of Contents
Introduction ......................................................................................................................1
Points of Attention for Inspections with Use of This Manual ..........................................3
Checklist for Business Management (Governance) (for Basic Elements) .......................6
Checklist for Legal Compliance.....................................................................................26
Checklist for Insurance Sales Management ...................................................................46
Checklist for Customer Protection Management ...........................................................73
Checklist for Comprehensive Risk Management .........................................................119
Checklist for Insurance Underwriting Risk Management ............................................178
Checklist for Asset Investment Risk Management.......................................................194
Checklist for Operational Risk, etc. Management........................................................263
Appendix
Checklist for Field Inspections.....................................................................................308
Introduction
Here, it covers all risks which could have a major effect on ensuring the soundness and appropriateness of the insurance company’s operations, not limited to the risks of each risk management system mentioned in this manual. In addition to cases where problems have occurred, major risks include risks which have not yet caused problems. In making such judgments, in addition to the extent to which problem occurrence will affect the business, the investigation must consider the possibility of the problem actually occurring. One must fully investigate vectors toward improvements and enhancements. (Is it heading towards improvement and enhancement? Do the initiatives cover a broad scope? Are the initiatives carried out with a sense of urgency?)
points which should be considered for improvement, and show them specifically. (5) Accurate understanding (“feeling of agreement”) of examination findings The inspector must use accurate examinations, dialogue and discussions with the management, etc., to obtain accurate understanding (“feeling of agreement”) of the examination findings, in order to lead to the insurance company’s proactive and dynamic efforts for business improvement.
3. This manual is intended to be a guide for inspections of insurance companies. Insurance
companies, for their part, should endeavor to ensure the soundness and appropriateness of their business and protect their customers, based on the principle of self-responsibility and under the leadership of management, by exploiting resourcefulness and creativity to develop policies and internal rules suited to their own scale and nature. This concept is shared by insurance companies and the authorities, in “Principles in the Financial Services Industry.”3 Meanwhile, insurance companies are not necessarily required to meet all of the criteria set forth in the check items of this manual. When using this manual, inspectors should take care not to apply the criteria mechanically and uniformly, in light of the company’s scale and nature. Therefore, even in a case where an insurance company does not literally meet the requirement of a check item, it should not be regarded as inappropriate if the arrangements and procedures put in place by the company are reasonable from the viewpoint of securing the soundness and appropriateness of its business and customer protection, and are thus deemed as effectively meeting the requirement or as sufficient in light of the company’s scale and nature. For example, if an insurance company does not have a division described in the checklist of each system, the inspector should review, with due consideration of the company’s scale and nature, whether its organization is structured in a way to enable the execution of necessary functions and a check-and-balance system. Published in April 18, 2008, as major norms and principles of conduct for how an insurance company conducts its business, and for administration by authorities. These principles present concepts, such as that financial service providers are expected to “1. pursue greater customer benefits and fulfill their expected roles through voluntary efforts with creativity” and “12. conduct appropriate risk management in accordance with the size and features of the business operation and inherent risk profile.”
Points of Attention for Inspections with Use of This Manual (1) This inspection manual shall apply to all insurance companies, including the overseas offices of Japanese insurance companies (overseas branches, locally incorporated entities, representative offices, etc. provided however, that the determination of whether to include these offices in the inspection subject to this manual shall be judged in view of applicable laws and regulations, including the local regulatory framework), as well as Japanese branches of foreign insurance companies, etc. and specified corporations. (2) When the insurance company is a company with a committee system, inspections shall be conducted from the viewpoint of whether the Board of Directors, committees (such as the nomination, compensation, and audit committees), executive officers, and other corporate structures exercise their empowered authority, etc., paying attention to the following points:
1) The authority to execute business is bestowed on executive officers, and in principle,
directors do not have the authority to execute business.
2) The Board of Directors may delegate, by resolution, the authority to make business
decisions to executive officers.
3) The purpose of the Board of Directors is to supervise the execution of the respective duties
performed by directors and executive officers.
4) Auditing authority is bestowed on the audit committee, and not on individual audit
committee members. (Audit committee members appointed by the audit committee may exercise the authority of the audit committee.) (3) In the case where an executive director (non-director) assumes the roles and responsibilities that would normally be assumed by a director in charge of a specific business operation, it is necessary to conduct a comprehensive review as to whether the Board of Directors has assigned the officer authority similar in effect to that which would be granted to a director in charge, whether the focus of the responsibility is made clear, and whether the Board of Directors sufficiently monitors the execution of the relevant business operation. Based on the findings thereof, the inspector should determine whether the executive officer is performing the roles and responsibilities required for a director in charge, as specified in the checklists of this manual. (4) Furthermore, when due to certain special reasons, it is necessary to conduct an inspection of subsidiaries, etc., of insurance companies or parties conducting business on their behalf, examinations as may be required shall be conducted in accordance with the applicable sections
of this manual.
(5) Unless specified otherwise, items expressed in the question form such as “does the company…” or “is the company…” refer to requirements that must be met by insurance companies. Meanwhile, items preceded by “It is desirable…” refer to best practices recommended for insurance companies, unless specified otherwise. With regard to items accompanied by “for example,” insurance companies are not required to fully comply letter-by-letter with the criteria and requirements specified therein. They are merely examples of items that may be useful for checking whether insurance companies are meeting certain criteria and requirements, in a manner befitting the scale and nature of their business. (6) The following are definitions and uses of some of the key terms in this manual
1) Items that are defined as roles of “the Board of Directors” are items for which the Board of
Directors itself needs to determine substantial matters related thereto. However, this shall not preclude another deliberative body, division or department from discussing draft proposals for decision.
2) The “Board of Directors or organization equivalent to the Board of Directors” includes, in
addition to the Board of Directors, other entities that decide matters concerning corporate management, with the participation of senior managers such as a council of managing directors and a corporate management council (hereinafter referred to as the “Council of Managing Directors, etc.”). It is desirable that decisions concerning items specified as the prerogatives of the Board of Directors or organization equivalent to the Board of Directors be made by the Board of Directors itself. In the case where the decision-making authority is delegated to the Council of Managing Directors, etc., it is necessary to make sure that the delegation has been made in a clear manner, that a follow-up review is provided for through the compilation of the minutes of meetings of the Council of Managing Directors, etc., and that a sufficient check-and-balance system is ensured, through arrangements such as requiring reports to be made to the Board of Directors, and allowing corporate auditors to attend meetings of the Council of Managing Directors, etc.
3) The “business locations” refers to organizations, other than the head office, which includes
branches, regional offices, business line headquarters, business offices, overseas branches, and overseas corporations. The term “business locations, etc.” refers to business locations, and also includes service centers (including loss investigation operations), overseas representative offices and other locations that are not engaged in sales activities, and business locations other than the head office.
4) The “manager” refers to persons in senior managerial positions in management divisions
(including directors). Furthermore, the term also refers to the head of a business location, or senior managers thereof (including directors) with levels of responsibility equivalent to or higher than the head of a business location.
5) The “employees, etc.” refers to employees, sales representatives, and insurance agents of
insurance companies.
6) The “insurance sales representatives” refers to sales representatives and insurance agents, but
does not include insurance brokers.
7) The “policyholders” refers to persons who are parties to insurance contracts with insurance
companies.
8) The “policyholders, etc.” refers to policyholders, insured persons, and beneficiaries.
9) “Internal rules” are rules that specify arrangements on an insurance company’s business in
accordance with its corporate management policy, etc. that are applicable within the company. It should be noted that internal rules do not necessarily have to specify detailed procedures.
10) The “marketing and sales division” refers to a division, department, or business location
engaged in sales business. For example, a division involved directly or indirectly in sales or engaged in sales promotion planning is a marketing and sales division.
11) The “legal checks, etc.,” which includes a compliance check, means, for example, a
validation of the consistency and compatibility of internal rules and the legality of transactions and business operations by personnel in charge of legal affairs, a division in charge thereof, personnel in charge of compliance, the compliance control division, and in-house or outside lawyers and other experts.
12) “Monitoring” refers to not only surveillance but also implementation of specific
pre-emptive measures such as issuing warnings.
13) The “risk profile” of a financial institution refers to the sum of features of various risks to
which the institution is exposed.
(Notes) Explanation of abbreviated terms
1) “Act”: Insurance Business Act
2) “Order”: Cabinet Order for Enforcement of the Insurance Business Act
3) “Ordinance”: Ordinance for Enforcement of the Insurance Business Act
4) “Supervisory Guidelines”: Comprehensive Guidelines for Supervision of Insurance
Companies
5) “Practical Guidelines”: Practical Guidelines for Actuaries of Life Insurance Companies or
Practical Guidelines for Actuaries of Non-Life Insurance Companies (The Institute of Actuaries of Japan)
Checklist for Business Management (Governance) (for Basic Elements) Checkpoints
on the social responsibilities and the public duties of insurance companies as an important task and provide a system to develop the establishment? (2) Development and Dissemination of Corporate Management Policy and Corporate Management Plan Does the Board of Directors clearly establish a corporate management policy for achieving the objectives set by the insurance company? Does it clearly formulate a corporate management plan in accordance with the corporate management policy and disseminate it throughout the company? (3) Development and Dissemination of Internal Control Basic Policy Does the Board of Directors establish a basic policy concerning the development of a system to secure the sound and appropriate management of the insurance company’s business (hereinafter referred to as the “Internal Control Basic Policy,”) in accordance with the corporate management policy and without delegating the task to the representative directors, etc. and disseminate it throughout the company?1 Is the Internal Control Basic Policy an appropriate one befitting the scales and natures of the company’s business? (4) Development and Dissemination of Strategic Objectives Does the Board of Directors clearly develop strategic objectives for the insurance company as a whole that include company-wide profit objectives and strategies for risk-taking and allocation of human and physical resources intended to help achieve the profit objectives, in accordance with the corporate management policy and without delegating the task to the representative directors, etc.? Does the Board of Directors clearly develop strategic objectives for each operational area based on the strategic objectives for the company as a whole and disseminate both the business-by-business and company-wide strategic objectives throughout the company? (5) Verification of Compatibility and Consistency of Risk Management Policies, etc. With regard to company-wide risk management, does the Board of Directors establish a Comprehensive Risk Management Policy and a management policy for various risks based on the strategic objectives for the company as a whole after verifying their compatibility and consistency?
2. Roles and Responsibilities of Directors and Board of Directors
(1) Roles and Responsibilities of Representative Directors and Non-Representative Directors (i) Do the directors regard legal compliance, proper insurance solicitation, customer protection and
1 The inspectors should review the document that includes the insurance company’s basic policy for developing a system for securing the soundness and appropriateness of its business regardless of the title of the document such as “Internal Control Basic Policy,” ”Internal Control Policy,” and “Internal Management Policy,” etc.
risk management as important corporate management tasks based on an understanding of the major points of Laws (including, but not limited to laws and regulations, etc. hereinafter referred to as the “Laws’’) applicable to the insurance company, the nature of the various risks to which the company is exposed, and the importance of customer protection, improvement in customer convenience and risk management? Do they understand the importance of audits by corporate auditors, internal audits2 , external audits and checking by actuaries in ensuring legal compliance, proper insurance solicitation, customer protection and risk management? (ii) Do the representative directors appropriately allocate human and physical resources in accordance with the corporate management policy, the corporate management plan, the Internal Control Basic Policy, the strategic objectives and the Comprehensive Risk Management Policy and appropriately exercise his/her authority so as to ensure flexible management thereof? (iii) Do the representative directors take specific measures to have officers and employees get acquainted with his/her approach to legal compliance, proper insurance solicitation, customer protection and risk management? For example, do the representative directors express his/her approach to legal compliance, proper insurance solicitation, customer protection and risk management to officers and employees when delivering a New Year’s speech and speaking at branch Managers’ meetings? (2) Check and Balance against Representative Directors Do non-representative directors engage in substantive debate at meetings of the Board of Directors and perform their duties of making decisions concerning business execution and supervising business execution in order to ensure appropriate business execution by exercising a check-andbalance system against the representative directors and preventing autocratic management? Is it ensured, for example, that under the rules governing the Board of Directors, decisions on matters concerning legal compliance, proper insurance solicitation, customer protection and risk management that would seriously affect the insurance company’s corporate management are treated as the exclusive prerogatives of the Board of Directors and judgment as to whether or not specific cases meet the criteria of “seriously affect” is not left to the representative directors? (3) Roles and Responsibilities of Outside Directors (in the case where outside directors have been appointed)
“Internal audits” refer to the process of review of the appropriateness and effectiveness of the internal control system of divisions (including risk management divisions. The same shall apply hereinafter.) and sales branches, etc. (including sales branches and overseas offices. The same shall apply hereinafter. Hereinafter referred to as the audited divisions, etc.) by a division in charge of internal audits (inspection division, operational audit division, etc.) that is independent from the audited divisions, etc. This process includes not only detecting and pointing out problems with the audited divisions’ administrative processes, etc. but also evaluating the internal control system and proposing improvement measures. In principle, it does not include inspections conducted by the audited divisions, etc. themselves as part of the internal control. The same shall apply hereafter.
Are outside directors aware of the significance of their roles and actively involved in meetings of the Board of Directors in order to ensure the objectivity of corporate management decision-making? Does the Board of Directors ensure that information concerning the conditions of the insurance company is provided to outside directors on an ongoing basis so as to enable them to make appropriate judgment at meetings of the Board of Directors? (4) Directors’ Duty of Care and Duty of Loyalty Do directors fully perform their duty of care and duty of loyalty in their execution of office, for example by engaging in substantive debate at meetings of the Board of Directors in order to ensure the sound and appropriate management of the insurance company’s business?
3. Development of Organizational Frameworks
(1) Development of Company-wide Organizational Framework Has the Board of Directors developed an organizational framework that enables the insurance company as a whole to conduct business and risk management appropriately and effectively, for example by establishing divisions between which conflicts of interest may arise and assigning them authority in a way to allow them to exercise a mutual check-and-balance system even as they maintain coordination? (2) Disclosure Does the Board of Directors provide a system to disclose information about financial conditions and other matters concerning the insurance company in an appropriate and timely manner? (3) Collection, Analysis and Examination of Information Concerning Insurance Company as a Whole (i) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to obtain, from within and outside the insurance company and in a timely manner, information concerning legal compliance, proper insurance solicitation, customer protection and risk management that is necessary for corporate governance? For example, does the Board of Directors or organization equivalent to the Board of Directors make sure to have access to necessary information, for example by having the Manager of each division report matters specified by it in a regular and timely manner or on an as needed basis or by installing a computer system function that enables directors and corporate auditors to survey information managed by each division? Moreover, does the Board of Directors or organization equivalent to the Board of Directors hear opinions from the manager of the Comprehensive Risk Management Division on matters regarding the comprehensive risk management situation, periodically or as needed? Does it investigate based on those opinions?
(ii) Does the Board of Directors or organization equivalent to the Board of Directors have in place procedures for the storage and management of information concerning the execution of business operations by directors, etc. in accordance with the Internal Control Basic Policy? For example, does it make sure to compile, store and manage the minutes of meetings of the Board of Directors or organizations equivalent to the Board of Directors? Does it also record instructions issued by the Board of Directors or organizations equivalent to the Board of Directors and documents related to its decisions and store and manage the records as necessary? (iii) Are the contents of the minutes of the meetings, when combined with the raw data used there, sufficient to confirm the agenda and substance of the meetings, such as matters reported to the Board of Directors or organizations equivalent to the Board of Directors (including the actual status of risk management, problems related to legal compliance, appropriateness of insurance solicitation, customer protection, inappropriate acts and other problems) and details of the approval given and decisions made by the Board of Directors or organization equivalent to the Board of Directors (including the process and substance of debate)? Is it ensured that the raw data used at these meetings is stored and managed for the same period of time as the minutes? (iv) Is it ensured that corporate auditors have easy access to the minutes of the meetings of the Board of Directors or organization equivalent to the Board of Directors or other information concerning directors’ execution of business operations? (4) Handling of New Products (i) Is the Board of Directors fully aware of the importance of management concerning handling of new products and start of new business and other matters (hereinafter referred to as “New Products Management” of “New Products, etc.”), from the viewpoint of protection of policyholders, etc., and that neglecting New Products Management has large effects on the maintenance of soundness and on ensuring appropriate business operations? Has the Board of Directors clearly established a policy on New Products Management (including matters concerning development and sale of new products, and improvement and elimination existing products. Hereinafter referred to as “New Products Management Policy.”) in accordance with the management policy and business plan? Also, based on the New Products Management Policy, has the Board of Directors developed a system which can provide integrated management for New Products Management? For example, are mutual restraining functions between new products related divisions fully demonstrated, such as by establishing a product development related management division and committee in charge (hereinafter referred to as “New Products Committee etc.”)?3 (ii) Has the Board of Directors developed a system to have the New Products Committee etc. collect information on the
appropriateness and legality of New Products Management, and sufficiently
3 This shall not preclude the Comprehensive Risk Management Division or other entities from conducting the New Products Screening,
study this? For example, is a system in place to ensure that:
(5) Management System of Subsidiaries, etc.
Does the Board of Directors or organization equivalent to the Board of Directors appropriately manage the business of subsidiaries, etc.4 in a manner befitting the scales and natures of their business and provide for measures to ensure that their business is appropriate from the viewpoint of legal compliance, proper insurance solicitation, customer protection and risk management? Does the Board of Directors or organization equivalent to the Board of Directors provide for measures to ensure that transactions between the insurance company and its subsidiaries, etc. are in compliance with the rules concerning the prevention of inappropriate practices and the “arms’ length rules”?
See Insurance Business Act, Article 97-2, Paragraph 3.
(6) Emphasis on Legal Compliance, Proper Insurance Solicitation, Customer Protection and Risk Management Does the Board of Directors or organization equivalent to the Board of Directors, instead of placing too much emphasis on the Marketing and Sales Division, etc., implement specific measures that attach importance to legal compliance, proper insurance solicitation, customer protection, comprehensive risk management, management of various risks and internal audits? For example, does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure that staff members engaged in operations related to legal compliance, customer protection, comprehensive risk management, management of various risks and internal audits are fairly treated in performance assessment and personnel evaluation and receive appropriate evaluation in light of the strategic importance of those operations? (7) Crisis Management System Does the Board of Directors or organization equivalent to the Board of Directors appropriately understand what constitutes a crisis for the insurance company and provide a system even in normal times to have an appropriate crisis management system in place so as to enable the management to respond immediately in the event of a crisis and take risk mitigation measures? For example, does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure that a crisis management manual and a business continuity plan (BCP) are formulated and that procedures for collecting information and responding to unfounded rumors in the event of a crisis are established?
4. Monitoring and Revision
Does the Board of Directors receive a report with regard to the status of business operations and the risks faced by the insurance company in a regular and timely manner or on an as needed basis and order an investigation as necessary to review the effectiveness and validity of the corporate management policy, the corporate management plan, the Internal Control Basic Policy, the strategic objectives, the Comprehensive Risk Management Policy, the policies concerning management of various risks, the Legal Compliance Policy, Insurance Solicitation Management Policy, the Customer Protection Management Policy and other policies as well as the effectiveness of the insurance company’s governance system based on these policies and revise them as necessary?
II. Development and Establishment of Internal Audit System
Internal Audit Implementation Guidelines) and approve it? Does the Internal Audit Implementation Guidelines reflect the actual status of operations at the divisions audited, etc. and enable the implementation of effective audits suited to the divisions’ operations? Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division establish operational procedures that specify details of the items subject to internal audits and the audit procedures where necessary? (3) Development of Internal Audit Plan (i) Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or the chief of the division grasp the status of legal compliance, insurance solicitation, customer protection and risk management at the divisions audited and formulate a plan for implementing internal audits in an efficient and effective manner with due consideration for the frequency and depth of necessary audits (hereinafter referred to as the “Internal Audit Plan”) and approve basic matters concerning the plan, including its key priority items? Does the Board of Directors or organization equivalent to the Board of Directors approve it after making sure that the Internal Audit Plan provides for additional audits as and when necessary? (ii) Does the Internal Audit Plan subject the operations of subsidiaries, etc. to internal audits within the limitations allowed under law? With regard to the operations of subsidiaries and operations commissioned to outsourcing contractors not subject to internal audits, does the plan subject the status of the management of those operations by divisions with the supervisory responsibilities thereof to internal audits? (4) Establishment of System of Internal Audit Division (i) Has the Board of Directors established an Internal Audit Division in charge of reviewing the appropriateness and effectiveness of the internal control system in accordance with the Internal Audit Policy and the Internal Audit Rules and does the Board provide a system to enable the division to perform its functions fully? (ii) Has the Board of Directors allocated in the Internal Audit Division a division chief with the necessary knowledge and experience to supervise the division and enabled the division chief to implement his/her operation by assigning him/her the necessary authority therefor? In the case where the chief of the Internal Audit Division concurrently takes charge of an operation subject to audits, is there an arrangement to secure the independence of the Internal Audit Division? (iii) Has the Board of Directors or organization equivalent to the Board of Directors allocated in the Internal Audit Division an adequate number of staff members with the necessary knowledge and experience as well as the expertise to sufficiently review the operations and assigned such staff the authority necessary for implementing the operations? Does the Board of Directors or organization
equivalent to the Board of Directors make sure to provide in-house and outside training to enhance
the expertise of staff members that conduct internal audits? It is desirable that there be a system to provide such training on an ongoing basis and that the relevant staff members regularly utilize it. (iv) Does the Board of Directors keep the Internal Audit Division independent from divisions subject to audits, etc. and secure the function of a check-and-balance framework? Does the Board of Directors provide a system to enable the Internal Audit Division to implement audits without being unduly restricted by divisions audited, etc.? Does the Board of Directors provide a system to prevent the Internal Audit Division from engaging in business activities or operations that should be conducted by divisions subject to audits, etc., such as compilation of information concerning financial conditions and other matters? (v) Does the Board of Directors provide a system to implement extraordinary audits aside from ordinary ones with regard to operations and computer systems susceptible to violation of Laws and practices? In the case where outside experts are employed to complement the audits of operations for which internal audits alone would not be sufficient, does the Board of Directors also assume responsibility for the audit process and results? (vi) Does the Board of Directors, in accordance with the Internal Audit Rules, assign staff members engaged in internal audits the authority to obtain any documents necessary for their execution of operations and interview or question any officer or employee when necessary for their execution of operations? (vii) Does the Board of Directors provide a system to disseminate the scope of the Internal Audit Division’s operations, authority and responsibilities to all of the officers and employees? (viii) Does the Board of Directors or organization equivalent to the Board of Directors allocate to overseas offices determined as being exposed to higher risk than a certain level internal auditors who are independent from the Managers of the offices and directly linked with the Internal Audit Division? (ix) Does the Board of Directors provide a system to have the results of internal audits reported in a timely and appropriate manner?
3) Systems for Follow-up
Improvement Steps by Board of Directors
With regard to problems included in internal audit reports that are determined as likely to seriously affect the corporate management or impossible for an audited division alone to handle, does the Board of Directors promptly take appropriate measures? Does it provide arrangements to have the Internal Audit Division conduct necessary follow-up audits on such cases, check the status of improvement and ensure that cases in which improvement is insufficient are reported to it?
2. Roles and Responsibilities of Internal Audit Division
(1) Development of Internal Audit Implementation Guidelines
Does the Internal Audit Division appropriately identify the items subject to audits, formulate an Internal Audit Implementation Guidelines that specifies the items subject to audits and the procedures for audit implementation and seek approval thereof from the Board of Directors or organization equivalent to the Board of Directors? Does the Internal Audit Implementation Guidelines exhaustively cover the items included in this checklist so as to enable effective audits? Where necessary, does the Internal Audit Division establish operational procedures that specify details concerning the items subject to internal audits and the audit procedures? (2) Development of Internal Audit Plan Does the Internal Audit Division formulate a plan for implementing internal audits in an efficient and effective manner with due consideration for the frequency and depth of necessary audits based on its understanding of the status of legal compliance, insurance solicitation, customer protection and risk management at the divisions audited and obtain approval by the Board of Directors or organization equivalent to the Board of Directors of basic matters concerning the plan, including its key priority items? Does the division subject the operations of subsidiaries, etc. to internal audits within the legal limitations? With regard to the operations of subsidiaries not subject to internal audits and operations commissioned to outsourcing contractors, does the division subject the status of the management of those operations by divisions with the supervisory responsibilities thereof to internal audits? (3) Implementation of Internal Audits (i) Does the Internal Audit Division implement internal audits of divisions subject to audits in an efficient and effective manner (by implementing an unannounced audit, for example) in accordance with the Internal Audit Implementation Guidelines and the Internal Audit Plan? Also, if insurance sales representatives cannot be audited by the Internal Audit Division at a certain frequency for unavoidable rational reasons, then are they inspected by the division in charge or by the sales branch at an equal or greater frequency? If so, is effectiveness ensured, with efforts to ensure effectiveness and correction of problems positioned equally? (ii) Does the Internal Audit Division, in accordance with the Internal Audit Rules, etc. seek to ensure fair audits, for example by preventing the same auditing staff member from continuing to audit the same division or preventing an auditing staff member from auditing the division in which he worked immediately before moving to the Internal Audit Division? (iii) Do auditing staff members accurately record the procedures followed in internal audits and problems detected therein? Do they compile, in accordance with the Internal Audit Implementation Guidelines and the Internal Audit Plan and without delay, internal audit reports that accurately reflect problems detected in internal audits? (iv) Does the
chief of the Internal Audit Division check the contents of internal audit reports, analyze
the frequency and the degree of importance, etc. of problems pointed out therein and report his/her findings to the Board of Directors without delay? In particular, does the chief of the Internal Audit Division report problems deemed likely to seriously affect the corporate management or significantly undermine customer interests to the Board of Directors without delay? Does the chief attend meetings concerning internal control (e.g. a meeting of a legal compliance committee) as necessary in order to report the status of internal audits and collect information? (v) In the case where the Internal Audit Division detects an obvious or suspected illegal act during the process of internal audits, does the division immediately report it to the Compliance Control Division?5 Does the Internal Audit Division accurately identify problems based on the analysis of internal audits and disseminate its findings to the Compliance Control Division, operational divisions and sales branches, etc. in a regular and timely manner or on an as needed basis? (4) Systems for Follow-Up Do divisions subject to internal audits take improvement measures without delay with regard to problems pointed out in internal audit reports with due consideration for the degree of their importance and formulate plans for improvement as necessary? Does the Internal Audit Division appropriately check the status of improvement at divisions subject to internal audits and reflect its findings in subsequent Internal Audit Plans?
3. Assessment and Improvement Activities
1) Analysis and Assessment
(1) Analysis and Assessment of Effectiveness of Internal Audits Does the Board of Directors appropriately determine whether there are any weaknesses or problems in the internal audit system and the particulars thereof, and appropriately examine their causes by precisely grasping the status of internal audits and analyzing and assessing the effectiveness of internal audits, based on all information available regarding the status of internal audits (including the status of compliance with the Internal Audit Implementation Guidelines and the Internal Audit Plan), such as the results of audits by corporate auditors, internal audits and external audits6 , findings of various investigations and reports from various divisions? In addition, if necessary, does it take all possible measures to find the causes by way of, for example, establishing fact findings committees, etc. consisting of non-interested persons? Does the chief of the Internal Audit Division analyze and assess the effectiveness of the Internal
5 See Checklist for Legal Compliance.
6 External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear it in mind that audits other than the audit of financial statements required under the rules and the verification of the internal control system conducted as part of the procedures of this audit are not obligatory. In the case where the insurance company inspected undergoes an external audit other than the audit of financial statements in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining the audit results in a comprehensive manner.
Audit Implementation Guidelines and the Internal Audit Plan in a regular and timely manner or on an as needed basis and report his/her findings to the Board of Directors? (2) Revision of Analysis and Assessment Processes Does the Board of Directors revise the analysis and assessment processes in a timely manner by reviewing their effectiveness based on reports and findings on the status of internal audits in a regular and timely manner or on an as needed basis?
2) Improvement Activities
(1) Improvement Activities Concerning Internal Audit System Does the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the internal audit system identified through the analysis, assessment and examination referred to in 3. 1) above in a timely and appropriate manner based on the results obtained by developing and implementing an improvement plan as required or by other appropriate methods? (2) Progress Status of Improvement Activities Does the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of Improvement Process Does the Board of Directors revise the improvement process in a timely manner by reviewing its effectiveness based on reports and findings on the status of internal audits in a regular and timely manner or on an as needed basis?
III. Development and Establishment of Auditing System by Corporate Auditors and Board of
Auditors
when there is a board of auditors, does each individual auditor actively conduct audits on their own responsibility as an independent agent? (3) Investigations of Subsidiaries Do corporate auditors pay attention to whether there is an appropriate internal control system within the corporate group of the insurance company and check the status of corporate governance and internal control at subsidiaries as necessary from the viewpoint of examining the status of directors’ execution of business operations for the purpose of securing the soundness of the business operations of the corporate group? (4) Attendance at Board of Directors’ Meetings Do corporate auditors appropriately examine the status of directors’ execution of business operations, for example, by attending meetings of the Board of Directors and expressing opinions as necessary? Do they also attend the Council of Managing Directors and express their opinions, as necessary, thus appropriately executing their auditing authority? (5) Employment of Outside Experts, etc. Do corporate auditors and the board of auditors employ lawyers, certified public accountants, insurance actuaries and other experts as necessary in order to supplement their functions? (6) Review of Audit Results Do corporate auditors and the board of auditors check whether the process of accounting audits by accounting auditors and the results thereof are reasonable and, if necessary, take measures such as making an appropriate proposal with regard to the replacement of an accounting auditor, for example? (7) Prevention of Illegal Acts When detecting an obvious or possible inappropriate act by a director, or when detecting a fact that violates laws or the articles of incorporation or a markedly unreasonable fact, do corporate auditors report it to the Board of Directors without delay? When they determine that a director’s act that violates laws or the articles of incorporation may significantly damage the insurance company, do corporate auditors take appropriate measures to halt the act? (8) Outside Auditors Do outside auditors fully perform their auditing functions by taking advantage of their positions? When an outside auditor serves on a non-permanent basis in particular, does he/she make sufficient efforts to maintain communications and coordination with permanent auditors so as to perform
his/her functions?
IV. Development and Establishment of External Audit System
(1) External Audit of Internal Control System by Accounting Auditors, Lawyers, etc. Does the insurance company undergo an external audit7 by an outside expert such as an accounting auditor and a lawyer at least once a year in order to review the effectiveness of the internal control system? In the case of an insurance company which has overseas offices, does the company check whether the company subjects each of its overseas offices to an external audit suited to the circumstances of the relevant country. Does the Board of Directors or the board of auditors receive audit results in a timely manner, corresponding to the audit’s content? (2) Cooperation to Effective Audits Does the Board of Directors provide for measures to have operational divisions and departments cooperate with external auditors to enable effective audits? (3) Analysis and Assessment of Effectiveness of External Audits Do the Board of Directors and the board of auditors regularly check whether external audits are functioning effectively? Do the Board of Directors and the board of auditors also make sure that external audits of subsidiaries are functioning effectively, for example by receiving reports concerning the results of external audits of subsidiaries, etc. so as to grasp any problem thereof? (4) Improvements and Follow-up Does the Board of Directors provide a system to implement improvements within a certain period of time with regard to problems pointed out by external auditors? Do divisions subject to audits implement improvements according to the level of the importance of the problems pointed out and formulate plans for improvements as necessary? Does the Internal Audit Division check the progress status of improvements appropriately?
7 External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear it in mind that audits other than the audit of financial statements required under the rules and the verification of the internal control system conducted as part of the procedures of this audit are not obligatory. In the case where the insurance company inspected undergoes an external audit other than the audit of financial statements in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining the audit results in a comprehensive manner.
V. Development and Establishment of System for Checking by Actuaries
(1) Appointment of Actuaries
(i) Does the Board of Directors follow the provisions of laws and regulations, and properly handle the appointments, resignations and dismissals of actuaries, from the viewpoint of maintaining the actuaries’ independence of duties ? (ii) Does the Board of Directors grant to actuaries the authority needed for execution of their duties? Also, is a system developed which enables demonstration of restraining functions, by ensuring actuaries’ independence from the Operating Division, the Marketing and Sales Division and the Product Development Division? (2) Roles of Actuaries (i) Are actuaries involved in the methods of calculating insurance premiums and other actuarial science related matters, from the viewpoints of equal treatment of customers and financial soundness, in accordance with laws and regulations? Also, regarding information needed for these purposes, are reports received from each related division? Moreover, do they fully perform their duties as actuaries, stating their opinions as needed, etc.? (ii) Do insurance actuaries appropriately check whether policy reserves are accumulated based on sound actuarial science, in accordance with laws and regulations? (iii) Do actuaries appropriately check whether policy dividends or dividends of surplus to policyholders have been distributed in a fair and equitable manner, in accordance with laws and regulations? (iv) Do actuaries analyze future revenues and expenditures, in accordance with laws and regulations? (v) Do actuaries appropriately check whether or not the situation of the enhancement of the ability to pay for insurance claims is appropriate, in accordance with laws and regulations? (vi) Do actuaries submit to the Board of Directors written opinions which write the matters established by laws and regulations? Do the actuaries appropriately explain their content, and submit copies to the authorities?
VI. Development and Establishment of Operation System for Meeting of Policyholder
Representatives (if a Mutual Company)
(1) Election of Policyholder Representatives
(i) Is the method of electing policyholder representatives (including screening procedures and screening criteria) clearly and simply shown in explanatory documents? Are its concepts and reasons explained at the meeting of policyholder representatives? Do explanatory documents clearly state the address to which opinions are to be sent? Does the method of electing policyholder representatives match that written in the articles of incorporation? (ii) Are policyholder representatives comprised of people who appropriately reflect the intentions of the policyholders, from the viewpoints of insurance types, ages, genders, occupations, time when policyholders obtained qualifications, regions, etc.? Is there sufficient number of policyholder representatives, needed in order to properly reflect the intentions of policyholders? Do explanatory documents clearly and simply show the reasons that the number of policyholder representatives are appropriate, and show the composition of all policyholders compared with the composition of policyholder representatives, and show the composition of policyholder representatives? Are these explained at the policyholder meeting? (iii) Is the policyholder representative candidates screening process fair and highly transparent? Considering the intention that general representatives are selected as representatives of members, are general representative candidates selected from among people who are already policyholders at the screening stage? (iv) If policyholder representatives are reappointed, are provisions established which limit reappointments to a number of years? (v) In a confidence vote, is plenty of information provided for the decision on each policyholder representative candidate, such as the opinions of the policyholder representative candidates and explanation of the election’s significance by the screening committee? (2) Operation of Meeting of Policyholder Representatives (i) Does the meeting of policyholder representatives work for solid management in accordance with laws and regulations, so the management supervision function is demonstrated appropriately in accordance with the system’s intention? (ii) At the meeting of policyholder representatives, in addition to matters written in the business report, is there clear and simple reporting of the solvency margin ratio and other matters with major effects on business, and of matters with major effects on customer interests? Also, other than when the meeting of policyholder representatives is held, is information on business conditions appropriately provided to the policyholder representatives? Also, is a
policy established on the collection of opinions from policyholder representatives, and are actions taken to inform other policyholder representatives about these collected opinions? (iii) Are policyholders who want to observe the meeting of policyholder representatives provided with this opportunity? Also, are efforts made to inform policyholders about this observation system? Are opportunities created to provide opinions and questions to the insurance company? (iv) Are the minutes of the meetings of policyholder representatives disclosed to policyholders?
Checklist for Legal Compliance
I. Development and Establishment of Legal Compliance System by Management
Checkpoints
but not limited to laws and regulations, etc.; hereinafter referred to as the “Laws’’) applicable to the insurance company’s business but also how to monitor the status of legal compliance and fully enforce compliance throughout the company? Based on such understanding, does the director appropriately grasp the status of legal compliance at the company and consider a policy and specific measures necessary for developing and establishing an appropriate legal compliance system? (2) Development and Dissemination of Legal Compliance Policy Has the Board of Directors established a basic policy regarding legal compliance (hereinafter referred to as the “Legal Compliance Policy” in accordance with the company’s corporate management policy and disseminated it throughout the company? (3) Revision of the Policy Development Process Does the Board of Directors revise the policy development process in a timely manner by reviewing its effectiveness based on reports and findings on the status of legal compliance in a regular and timely manner or on an as needed basis?
However, the Insurance Sales Management Division is the division which primarily manages compliance with laws and regulations on insurance solicitation. 2 However the Insurance Sales Management Division is the division which primarily collects, manages, analyzes and studies sales compliance information (refer to the Checklist for Insurance Sales Management).
the company’s divisions and departments and, based on the results of the analysis and examination, take appropriate steps and measures. From such a point of view, does the Board of Directors or organization equivalent to the Board of Directors have the Compliance Control Division, established in accordance with the Legal Compliance Policy and the Legal Compliance Rules, clarify its areas of responsibilities and assign it the necessary authority so as to enable the division to perform its roles and functions appropriately?3 (ii) Has the Board of Directors allocated to the Compliance Control Division a Manager with the necessary knowledge and experience to supervise the division and enabled the Manager to implement management operations by assigning him/her the necessary authority therefor? (iii) Has the Board of Directors or organization equivalent to the Board of Directors allocated to the Compliance Control Division an adequate number of staff members with the necessary knowledge and experience to execute the relevant operations and assigned such staff the authority necessary for implementing the operations?4 (iv) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to secure a check-and-balance system of the Compliance Control Division through measures including keeping the Compliance Control Division independent from the Marketing and Sales Division? In the case where the Compliance Control Division also takes charge of another business, the inspector should give consideration in particular to whether there is a system to prevent interference from the Marketing and Sales Division, etc. (v) Does the Board of Directors or organization equivalent to the Board of Directors provide a system which sufficiently works as needed on mutual coordination and cooperation between the Compliance Control Division and the Insurance Sales Management Division, regarding matters concerning insurance sales which are part of legal compliance? (3) Development of Legal Compliance System in Operation Divisions and Business Locations, etc. (i) Does the Board of Directors or organization equivalent to the Board of Directors work through the Manager or the Compliance Control Division, to provide a system to ensure the effectiveness of legal compliance? For example, informing operating divisions and business
When the Compliance Control Division is not established as an independent division (e.g., when the division is consolidated with another risk management division to form a single division or when a division in charge of other business also takes charge of compliance control or when a Manager or Managers take charge of compliance control instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division commensurate with the scales and natures of the insurance company and its risk profile. When a department or a post other than the Board of Directors or organization equivalent to the Board of Directors is empowered to allocate staff and assign them authority, the inspector shall review, in light of the nature of such a department or post, whether or not the structure of the Compliance Control Division is reasonable in terms of a check-and-balance system and other aspects.
locations about the laws and regulations, relevant internal rules and operational procedures5 which must be followed, and ensuring compliance? For example, does the Board of Directors or organization equivalent to the Board of Directors instruct the Manager or the Compliance Control Division to identify the Laws, internal rules and operational procedures to be observed by the operation divisions and to regularly carry out specific measures for ensuring observance such as providing effective training suited to the nature and responsibilities of the operations? (ii) Does the Board of Directors or organization equivalent to the Board of Directors allocate a person in charge of compliance to each operation division and business location for coordination with the Compliance Control Division, etc.? With regard to operation divisions and business locations for which it is especially necessary to secure the effectiveness of the legal compliance system, for example because it is difficult to monitor their operations (e.g. overseas branches), does the Board of Directors allocate a compliance officer responsible for securing legal compliance at such divisions and branches and ensure that coordination with the Compliance Control Division, etc. is maintained through the coordination between the compliance officer and the Manager while keeping independence from the Marketing and Sales Division? (iii) Does the Board of Directors provide a system to establish firewalls and take other measures to block the flow of information when necessary from the viewpoint of legal compliance according to the scales and natures of the company’s business? Cases that require such measures include when the prevention of insider trading or management of conflicts of interest, etc. is necessary, for example. (4) Development and Dissemination of Compliance Manual Does the Board of Directors have the Manager establish, in accordance with the Legal Compliance Policy and the Legal Compliance Rules, a manual that explains the Laws that officers and employees must comply with (hereinafter referred to as the Compliance Manual) and provides specific instructions as to what measures should be taken when illegal acts are detected and disseminate the manual throughout the company upon approval by the Board of Directors or organization equivalent to the Board of Directors? Is an important revision of the Compliance Manual subject to approval by the Board of Directors? (5) Development and Dissemination of Compliance Program Does the Board of Directors have the Manager formulate, in accordance with the Legal Compliance Policy and the Legal Compliance Rules, a program for implementing specific measures to ensure compliance (including the development of internal rules and planning of
5 Operational procedures are rules established, revised and abolished by a person or a division empowered by the Board of Directors or organization equivalent to the Board of Directors to do so and are subsidiary to internal rules.
employee training. Hereinafter referred to as the “Compliance Program”) at least once a year and disseminate it throughout the company upon approval by the Board of Directors? Do the representative directors and the Board of Directors regularly and accurately grasp the progress and achievement status of the Compliance Program? Do they provide a system to reflect the implementation status of the Compliance Program in the performance assessment and personnel evaluation? (6) Arrangement for the System of Reporting to Board of Directors or organization equivalent to Board of Directors and Approval Has the Board of Directors or organization equivalent to the Board of Directors appropriately specified matters that require reporting and those that require approval and does it have the Manager report the current status of legal compliance to the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner or on an as needed basis or have the Manager seek the approval of the Board of Directors or organization equivalent to the Board of Directors on the relevant matters? In particular, does it ensure that the Manager reports to the Board of Directors or organization equivalent to the Board of Directors without delay any matters that would seriously affect corporate management or significantly undermine customer interests? (7) Arrangement for System of Reporting to Corporate Auditor In the case where the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately and does it provide a system to have the Manager directly report such matters to the auditor?6
(8) Development of Internal Audit Guidelines and Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or the manager of the Internal Audit Division appropriately identify the matters to be audited with regard to legal compliance, develop guidelines that specify the matters subject to internal audit and the audit procedure (hereinafter referred to as “Internal Audit Guidelines”) and an internal audit plan, and approve such guidelines and plan?7
(9) Revision of Development Process of Internal Rules and Organizational Frameworks Does the Board of Directors or organization equivalent to the Board of Directors revise the development process of internal rules and organizational frameworks in a timely manner by reviewing its effectiveness based on reports and findings on the status of legal compliance in a regular and timely manner or on an as needed basis?
It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report and shall not restrict the authority and activities of the auditor in any way. 7 The Board of Directors or organization equivalent to the Board of Directors only needs to have approved the basic matters with regard to an internal audit plan.
1) Analysis and Assessment
(1) Analysis and Assessment of Legal Compliance System Does the Board of Directors or organization equivalent to the Board of Directors appropriately determine whether there are any weaknesses or problems in the legal compliance system and the particulars thereof, and appropriately examine their causes by precisely analyzing the status of legal compliance and assessing the effectiveness of the legal compliance system, based on all information available regarding the status of legal compliance, such as the results of audits by corporate auditors, internal audits and external audits,8 findings of various investigations and reports from various divisions? In addition, if necessary, does it take all possible measures to find the causes by way of, for example, establishing fact findings committees, etc. consisting of noninterested persons? (2) Revision of Analysis and Assessment Processes Does the Board of Directors or organization equivalent to the Board of Directors revise the analysis and assessment processes in a timely manner by reviewing their effectiveness based on reports and findings on the status of legal compliance in a regular and timely manner or on an as needed basis?
2) Improvement Activities
(1) Implementation of Improvements
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the legal compliance system that are identified through the analysis, assessment and review referred to in 3.
1) above in a timely and appropriate manner based on the results obtained by developing and
implementing an improvement plan as required or by other appropriate methods? (2) Progress Status of Improvement Activities Does the Board of Directors or organization equivalent to the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of the Improvement Process Does the Board of Directors or organization equivalent to the Board of Directors revise the improvement process in a timely manner by reviewing its effectiveness based on reports and
8 External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear in mind that currently, audits other than the audit of financial statements required under the rules and the verification of the internal control system conducted as part of the procedures of this audit are not obligatory. However, in the case where the inspected insurance company undergoes an external audit other than the financial statements audit in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining in a comprehensive manner along with the financial statements audit results.
findings on the status of legal compliance in a regular and timely manner or on an as needed basis?
II. Development and Establishment of Legal Compliance System by Manager
Checkpoints
Control Division
2) Development of System
(1) Development of System of the Compliance Control Division by Manager (i) Does the Manager, in accordance with the Legal Compliance Policy and the Legal Compliance Rules, provide a system to have the Legal Compliance Division prepared to exercise a checkand balance in order to make absolutely sure to pre-empt violation of Laws and prevent the recurrence of past violation of Laws ?
(ii) Does the Manager ensure the system of training and education to enhance the ability and knowledge of employees with regard to legal compliance, thus developing human resources with relevant expertise? (2) Collection, Management, Analysis and Examination of Compliance-Related Information Does the Manager provide for measures to collect in an efficient and timely manner Compliance-related Information scattered across the company’s divisions and departments according to the nature of the company’s business? Does the Manager provide a system to appropriately manage the Compliance-related Information collected and analyze it so as to use it to pre-empt violation of Laws and prevent the recurrence of the past violation of Laws? For example, does the Manager provide for a means of reporting by establishing a “help line,” a “compliance hot line,” etc.? (3) Communication and Coordination System (i) Does the Manager, in person or through the Compliance Control Division, maintain close communication and coordination with divisions which hold Compliance-related Information? (ii) Does the Manager maintain coordination with a person in charge of compliance allocated to each operation division and business location, etc.? (4) Monitoring System Does the Manager, in order to ensure appropriate legal compliance at each division, make sure to monitor the status of compliance on an ongoing basis by requiring each division in a regular and timely manner or on an as needed basis to report the status of its compliance, to collect information from persons in charge of enforcing compliance on an ongoing basis or to conduct a field survey, for example? (5) System for Handling Violation of Laws Does the Manager provide a system to ensure that an investigation is promptly conducted in response to a report about a suspected violation of Laws if the suspicion is determined as justified as a result of analysis of Compliance-related Information and review whether or not the company is required under law to report the case to the authorities and report it when necessary? (The Manager may have a suitable division or department other than the Compliance Control Division investigate, review and report such a case.) Does the Manager provide a system to make an appropriate disclosure under the Financial Instruments and Exchange Act?9 (6) Coordination with Customer Support Manager (i) Does the Manager, in coordination with the Customer Support Management10, provide a system to collect information in a prompt and wide-ranging manner with regard to
This shall apply only to insurance companies subject to timely disclosure rules under the Financial Instruments and Exchange Act. 10 See Checklist for Customer Protection Management.
Consultation Requests, Complaints, etc. 11 from customers that should be recognized as legitimate complaints and that may develop into legitimate complaints? (ii) With regard to complaints that involve information related to violation of Laws, including suspected ones, does the Manager provide a system to require and obtain reports from divisions, departments and individuals that hold the relevant information and analyze and examine it so as to provide feedback to the division in charge of processing complaints? (iii) Does the Manager provide a system to have a non-interested party conduct appropriate and sufficient investigations to identify the cause with regard to complaints determined as requiring such action? (7) Cooperation with Insurance Sales Management Division Does the Manager provide a system for appropriate cooperation with the Insurance Sales Management Division, in order to solve compliance issues which require company-wide initiatives? (8) System for Training and Guidance Has the Manager fully disseminated the details of the Compliance Manual to all of the officers and employees? Does the Manager make sure to provide sufficient training and guidance with regard to the Laws that must be complied with in each operation? Do all of the employees get fully acquainted with the need to prevent violation of Laws through training sessions and workplace morning assemblies, etc.? (9) System for Reporting to Board of Directors or organization equivalent to Board of Directors and Approval Does the Manager provide a system to report matters determined as necessary by the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner or on an as needed basis? In particular, does the Manager report to the Board of Directors or organization equivalent to the Board of Directors without delay any matter that would seriously affect corporate management or significantly undermine customer interests? (10) System for Reporting to Corporate Auditor Does the Manager report matters specified by the Board of Directors directly to a corporate auditor?
3) Assessment and Improvement Activities
Does the Manager review the effectiveness of the Compliance Control Division’s enforcement of legal compliance in a regular and timely manner or on an as needed basis based on the reports and the results of investigations concerning the status of legal compliance, including the status of compliance with the Compliance Manual and various rules, as well as based on the results of monitoring? Does the Manager present the Board of Directors or organization equivalent to the
11 See Checklist for Customer Protection Management.
Board of Directors with proposals for improvement as necessary by revising in a timely manner the various rules (including the Compliance Manual), the organizational framework, the implementation of training and guidance and the method of monitoring?
authorities as required under law, whether or not to report it as a suspicious transaction and whether or not to disclose it publicly? (iii) Does the Compliance Control Division investigate the background and cause of a violation of Laws act and the extent of its impact or have a non-interested division or department conduct such an investigation and then analyze the case and report the results of the analysis to the Manager? (iv) Does the Compliance Control Division feed back the results of the analysis mentioned above to the Managers of the relevant divisions and business locations in order to prevent the recurrence of the case and promptly take prevention measures or have another division do so? (5) Coordination with Customer Support Manager (i) Does the Compliance Control Division appropriately maintain coordination with the Customer Support Manager as required under the Customer Protection Management System and provide advice to help facilitate customer support? (ii) Does the Compliance Control Division collect information in a prompt and wide-ranging manner with regard to requests for consultations and complaints from customers12 that should be recognized as legitimate complaints or that are likely to develop into legitimate complaints? (iii) With regard to requests for consultations and complaints that involve information concerning violation of Laws, does the Compliance Control Division require and obtain reports from divisions, departments and individuals that hold the relevant information in an appropriate manner, analyze and examine the information and provide feedback to the division in charge of processing complaints? (iv) Does the Compliance Control Division have non-interested parties conduct appropriate and sufficient investigations to identify the cause with regard to requests for consultations and complaints determined as requiring such action? (6) Cooperation with Insurance Sales Management Division Does the Compliance Control Division appropriately cooperate with the Insurance Sales Management Division, in order to solve compliance issues which require company-wide initiatives? (7) Roles of Persons in Charge of Compliance Do persons in charge of compliance keep under unified control Compliance-related Information at the divisions and departments to which they are allocated, communicate the information to the Compliance Control Division in a regular and timely manner or on an as needed basis and appropriately engage in efforts to ensure compliance at the divisions and departments? Do they perform their functions fully based on the legal knowledge accumulated with regard to their operations?
12 See Checklist for Customer Protection Management.
Checkpoints
of matters determined as subject to legal checks, etc. does the company conduct careful prior examination from the legal and compliance perspective? For example, does the company provide a system to conduct especially careful examination with regard to the legality of the following matters? Are the range of documents, transactions and businesses subject to legal checks, etc. and the focus of responsibility for the checks specified and disseminated throughout the company?
(iii) Is the management of funds and other assets received as insurance premiums conducted in a manner stipulated by laws and regulations, such as for investments in securities? (iv) Does the insurance company invest assets stipulated by laws and regulations in excess of the amount calculated in accordance with the provisions of laws and regulations? Is the amount of assets invested by the insurance company in a single entity (including parties with special connections therewith) in excess of the amount calculated in accordance with the provisions of laws and regulations?13 (v) Is the insurance company engaged in the purchase and sale of assets or any other transactions with persons in specified relationships, etc., under terms and conditions substantially different from those of normal transactions of the insurance company? (vi) Have the insurance company and its subsidiaries in aggregate acquired or are they now holding voting rights of domestic companies (other than their own subsidiaries) that are in excess of the limit allowed by laws and regulations? (2) Ancillary Business Operations When determining whether business operations of the insurance company are subject to the scope of the “the following and other business operations ancillary thereto” set forth in Article 98, Paragraph 1 of the Law, is it fully taken into account that engagement in business operations other than those provided for in the Law is banned under Article 100 of the Law, and is due attention paid to the following points? (i) whether the operations in question are similar in nature to the business operations listed in
Article 97 and Article 98, Paragraph 1 of the Law;
(ii) whether the magnitude of the operations in question is not overly excessive in comparison to the proper business operations to which such business operations are ancillary; (iii) whether such business operations have functional similarities or homogeneity of risks with the insurance business; and (iv) whether such business operations contribute to the utilization of surplus capacity of the insurance company justly resulting from the pursuit of the proper business operations of the insurance company. (3) Scope of the Business Operations of Subsidiaries, etc., of Insurance Companies Are subsidiaries of the insurance company14 subject to any item listed in Article 106 of the Law15? Are subordinate business operations (Article 106, Paragraph 2, Item 1 of the Law) and
13 In cases when the insurance company has subsidiaries, etc., it shall be noted that the combined amount of assets invested in a single entity by the insurance company and its subsidiaries, etc., cannot exceed the amount calculated in accordance with the provisions of laws and regulations. 14 Regardless of whether such insurance companies prepare business reports, etc., in accordance with the Financial Instruments and Exchange Act, the determination of qualifying subsidiary corporations and affiliated corporations, etc., shall duly consider whether the following are observed: “Regulations Concerning Terminology, Forms and Methods of Preparation of Financial Statements,” “Implementation Guidance on Determining a Subsidiary and an Affiliate” (issued by the Accounting Standards Board of
financing-related business operations (Item 2 of said Article and Paragraph) conducted by subsidiaries in compliance with statutory requirements and the standards concerning subsidiaries set forth in public notices and the Supervisory Guidelines?
4. Handling of Anti-Social Forces
(1) Development and Dissemination of Policy on Handling of Anti-Social Forces, Compliance Manual, etc. (i) Do directors fully understand that prohibiting association with anti-social forces and excluding such forces firmly is vital for maintaining public confidence in the insurance company and securing the appropriateness and soundness of the company’s business? (ii) Has the Board of Directors made clear the policy of prohibiting association with anti-social forces and excluding such forces firmly and disseminated the policy to all of the company’s officers and employees? (iii) Does the Compliance Manual explain how to handle anti-social forces in an easy-to-understand way and clearly indicate the contact information concerning the section and person in charge of such handling? Is a similar arrangement in place at subsidiaries etc. as necessary? (2) Development of System for Handling of Anti-Social Forces Does the Board of Directors have such an organizational framework as mentioned below in place to handle anti-social forces systematically?16 (i) Does the company have a department in charge of collecting and analyzing internal and external information concerning anti-social forces and managing such information in an integrated manner? (ii) Is there a system for conducting prior screening to prevent transactions with anti-social forces? (iii) Is there a framework for collaboration and communications across the relevant divisions? (3) Roles of Department in Charge of Handling of Anti-Social Forces (i) When contacted by an officer or employee with regard to how to handle anti-social forces, does the department in charge provide guidance to ensure appropriate handling while maintaining coordination with the police, administration, lawyers and bar association as necessary?
Japan on May 13, 2008), and other generally accepted accounting principles. 15 “Corporations” as defined in Articles 106 and 107 of the Law do not include special purpose corporations, associations, investment corporations, partnerships, limited liability companies, or any other business entities equivalent to corporations (hereafter, “business entities equivalent to corporations”). Attention shall be paid to whether the purposes of the regulations of the scope of business operations of subsidiaries, etc., and prohibitions of engaging in other business operations are evaded through business entities equivalent to corporations. 16 Refer as necessary to “Manual for Implementing Charter of Corporate Code” by Nippon Keidanren, etc.
(ii) Has the department in charge disseminated the rules for handling anti-social forces and the relevant portions of the Compliance Manual to all of the officers and employees through training, guidance, etc.?
5. Customer Identity Verification
(1) Development of Internal Rules Concerning Customer Identity Verification Does the Board of Directors or organization equivalent to the Board of Directors have internal rules concerning customer identity verification (hereinafter referred to as the “Customer Identity Verification Rules”) established? Are the Customer Identity Verification Rules subject to legal checks, etc. and approval by the Board of Directors or organization equivalent to the Board of Directors? Do the Customer Identity Verification Rules clarify the situations in which identity verification must be done, for example when signing an insurance contract with a customer?17 (2) Development of Customer Identity Verification System (i) Does the Board of Directors or organization equivalent to the Board of Directors have a person in charge of customer identity verification appointed or a department in charge thereof established? (ii) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure that matters concerning customer identity verification that would seriously affect corporate management are reported to the Compliance Control Division, the Internal Audit Division and the Board of Directors or organization equivalent to the Board of Directors without delay? (iii) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure that records on customer identity verification and transactions are compiled and stored appropriately? (3) Guidance and Training Concerning Customer Identity Verification Does the person or department in charge of customer identity verification disseminate the Customer Identity Verification Rules to all of the relevant employees by providing guidance and training regularly or through other means in order to ensure that customer identity verification is conducted in a timely and appropriate manner? (4) Points of Attention Concerning Customer Identity Verification (i) When verifying the identity of a corporate customer, does the company verify the identity of the corporation’s person in charge of transactions?
17 The Customer Identity Verification Rules may not be available as a single set of rules in some cases, and they may be integrated with the Compliance Manual, etc. in other cases. The inspector should empirically review, regardless of the form of rules, whether or not the rules exhaustively stipulate necessary matters and are fully disseminated to the personnel who should be acquainted with them, upon approval by the Board of Directors or organization equivalent to the Board of Directors, thus ensuring an effective customer identity verification system.
(ii) With regard to a transaction conducted through an agent, does the company verify the identity of both the customer and the agent? (iii) With regard to a transaction for which a customer identity verification has been already done, does the company re-check the customer identity where required by laws and ordinances? (iv) With regard to a case in which a customer identity verification of a customer has been done at an overseas head office, branch office, subsidiary or affiliate, does the company re-check the identity of the customer when he or she signs an insurance contract in Japan as required by laws and ordinances?
6. Suspicious Transactions
(1) Development of Internal Rules Concerning Suspicious Transactions Does the company have in place internal rules concerning money laundering and other suspicious transactions (hereinafter referred to as the Suspicious Transaction Rules) concerning such transactions? Are the Suspicious Transaction Rules subject to legal checks, etc. and approval by the Board of Directors or organization equivalent to the Board of Directors? For example, do the rules specify the following arrangements?
information concerning the attributes of the party concerned, the situation at the time of the transaction and other details related to the transaction that the insurance company holds? (iv) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to have the person or department in charge of handling suspicious transactions regularly report to the Board of Directors or organization equivalent to the Board of Directors the key points of reports from business locations, etc. with regard to suspicious transactions? (v) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure that matters concerning suspicious transactions that would seriously affect corporate management are reported to the Compliance Control Division and the Internal Audit Division as well as the Board of Directors or organization equivalent to the Board of Directors without delay? (vi) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure that all suspicious transactions are reported to the authorities? (3) Guidance and Training Concerning Suspicious Transactions Does the person or department in charge of handling suspicious transactions seek to ensure that suspicious transactions are reported and other appropriate measures are taken with regard to such transactions in a timely manner by regularly providing guidance and training to the relevant employees? (4) Points of Attention in Examining Suspicious Transactions (i) Does the company build a database of cases of suspicious transactions and disseminate the obtained results throughout the relevant divisions by compiling reference casebook depicting examples of suspicious transactions, for example? (ii) Does the company fully collect and accumulate information concerning the attributes of the parties the transactions with whom should be treated as suspicious transactions and the nature of suspicious transactions? (iii) It should be noted that in the case where the number of suspicious transactions reported by the company is markedly small relative to the scales and natures of its business, it is necessary to carefully verify whether the company’s judgment criteria for suspicious transactions are effective.
Checklist for Insurance Sales Management
I. Status of Development and Establishment of Insurance Sales Management System by
Management
Checkpoints
with laws and regulations on insurance sales?
Also, does the director in charge of insurance sales management understand the content of laws and regulations on insurance sales, and also fully understand methods of monitoring the status of compliance with such laws and regulations, and methods for thorough compliance with such laws and regulations? Based on this understanding, is the director accurately aware of that insurance company’s status of compliance with such laws and regulations? While considering the characteristics of the insurance company’s sales channels, does he investigate policies and specific actions to develop and establish a proper insurance sales management system? (2) Development and Dissemination of Insurance Sales Management Policy Has the Board of Directors established a policy regarding insurance sales management (hereinafter referred to as the “Insurance Sales Management Policy”) in accordance with business policy, and informed the organization and insurance sales representatives about this policy? Does it devise methods of informing insurance sales representatives about this, considering their attributes? (3) Revision of Policy Development Process Does the Board of Directors revise the policy development process in a timely manner, by reviewing its effectiveness based on reports and findings of various investigations on the status of comprehensive risk management, in a regular and timely manner or on an as needed basis?
2. Development of Internal Rules and Organizational Frameworks
(1) Development and Dissemination of Internal Rules Does the Board of Directors or organization equivalent to the Board of Directors have the manager (hereinafter simply referred to as the “Manager” in this checklist) of the division in charge of insurance sales management (hereinafter referred to as the “Insurance Sales Management Division”) develop internal rules that clearly specify the arrangements concerning insurance sales (hereinafter referred to as the “Insurance Sales Management Rules”) and inform the entire organization and insurance sales representatives about these rules, in accordance with the Insurance Sales Management Policy? Does the Board of Directors or organization equivalent to the Board of Directors approve the Insurance Sales Management Rules, after determining whether they comply with the Insurance Sales Management Policy and after legal checks, etc.? (2) Establishment of Insurance Sales Management Division (i) Does the Board of Directors or organization equivalent to the Board of Directors have an Insurance Sales Management Division established, clarify the matters it is in charge of,
grant its authority, and have the division prepared to undertake appropriate roles and functions, in accordance with the Insurance Sales Management Policy and the Insurance Sales Management Rules?1 (ii) Has the Board of Directors allocated to the Insurance Sales Management Division a Manager with the necessary knowledge and experience to supervise the division, and enabled the Manager to execute management operations by assigning to him/her the necessary authority therefor? (iii) Has the Board of Directors or organization equivalent to the Board of Directors allocated to the Insurance Sales Management Division an adequate number of staff members who have the necessary knowledge and experience to execute the relevant operations, and assigned such staff the authority necessary for conducting the aforementioned operations?2 (iv) Does the Board of Directors or organization equivalent to the Board of Directors keep the Insurance Sales Management Division independent from the Marketing and Sales Division, etc. and secure a check-and-balance system of the Insurance Sales Management Division? Especially if the Insurance Sales Management Division is also in charge of other operations, does the Does the Board of Directors or organization equivalent to the Board of Directors pay attention to having a system to prevent interference from the Marketing and Sales Division, etc.? (v) Does the Board of Directors or organization equivalent to the Board of Directors develop a system which works for sufficient coordination and cooperation as needed between the Insurance Sales Management Division and the Compliance Control Division? (3) Development of Insurance Sales Management System regarding Marketing and Sales Division and Insurance Sales Representatives Does the Board of Directors or organization equivalent to the Board of Directors develop a system to ensure effectiveness of insurance sales management? For example, does it develop a system for the Manager or the Insurance Sales Management Division to inform the Marketing and Sales Division, etc. and insurance sales representatives of insurance sales management related laws and regulations, internal rules and operational procedures which must be observed?
When the Insurance Sales Management Division is not established as an independent division (e.g., when the division is consolidated with the Compliance Control Division or other division to form a single division, or when a division in charge of other business also takes charge of insurance sales management, or when a Manager or Managers take charge of insurance sales management instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division, commensurate with the scale and nature of the insurance company. department or post, whether or not the structure of the Comprehensive Risk Management Division is reasonable in terms of a check-and-balance system and other aspects.
For example, does the Board of Directors or organization equivalent to the Board of Directors instruct the Manager or Insurance Sales Management Division to identify the laws and regulations, internal rules and operational procedures that must be observed by the Marketing and Sales Division, etc. and insurance sales representatives, to carry out specific actions such as providing effective training on a regular basis? (4) Development and Dissemination of Insurance Sales Compliance Manual Does the Board of Directors or organization equivalent to the Board of Directors have the Manager create a handbook which explains the laws and regulations which officers and employees must follow regarding insurance sales, and shows specific procedures such as customer explanations which must be provided for proper insurance sales (hereinafter referred to as the “Insurance Sales Compliance Manual”), and make it known in the organization and to insurance sales representatives, after the Board’s approval, in accordance with the Insurance Sales Management Rules and Insurance Sales Management Policy? Does the Board of Directors approve major revisions of the Insurance Sales Compliance Manual? (5) Development and Dissemination of Insurance Sales Compliance Program Does the Board of Directors have the Manager develop internal rules, a specific practical plan, employee training plan, etc., to achieve compliance regarding insurance sales (hereinafter referred to as the “Insurance Sales Compliance Program”), created at least once each fiscal year, in accordance with the Insurance Sales Management Rules and Insurance Sales Management Policy? Does the Board of Directors approve this and have the Manager inform the entire organization?3 Are its progress status and achievement status periodically and accurately understood and assessed by the Representative Director and Board of Directors? Is a system developed to have the execution status of the Insurance Sales Compliance Program equally considered in performance assessments and personnel reviews, etc.? (6) Development of System for Reporting to and Approval by the Board of Directors or Organization Equivalent to Board of Directors Has the Board of Directors or organization equivalent to the Board of Directors appropriately specified matters that require reporting and those that require approval, and does it have the Manager report the insurance sales management status to the Board of Directors or equivalent organization equivalent to the Board of Directors periodically or on an as needed basis, or have the Manager seek the approval of the Board of Directors or organization equivalent organization to the Board of Directors on the relevant matters? In particular, does it develop a
The Insurance Sales Compliance Program could be integrated with the compliance program (refer to the Checklist for Legal Compliance), etc. in some cases. The inspector should empirically review, regardless of the form of program, whether or not a specific practical plan is created for achieving compliance regarding insurance sales, and after approval by the Board of Directors, the entire organization is thoroughly informed, thus ensuring appropriate execution of insurance sales.
system for the Manager to quickly report to the Board of Directors or equivalent organization to the Board of Directors any matters that would seriously affect corporate management or remarkably impair customer interests? (7) System for Reporting to Corporate Auditor In the case that the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately, and do they provide a system to have the Manager directly report such matters to the auditor?4 (8) Development of Internal Audit Guidelines and Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or Internal Audit Division Manager appropriately identify the matters to be audited with regard to insurance sales management, develop guidelines that specify the matters subject to internal audit and the audit procedure (hereinafter referred to as “Internal Audit Guidelines”) and an internal audit plan, and approve such guidelines and plan?5 (9) Revision of Development Process of Internal Rules and Organizational Frameworks Does the Board of Directors or organization equivalent to the Board of Directors revise the process of developing internal rules and organizational frameworks in a timely manner by reviewing their effectiveness based on reports and findings on the status of insurance sales management in a regular and timely manner or on an as needed basis?
3. Assessment and Improvement Activities
1) Analysis and Assessment
(1) Analysis and Assessment of Insurance Sales Management Does the Board of Directors or organization equivalent to the Board of Directors appropriately determine whether there are any weaknesses or problems in the insurance sales management system and the particulars thereof, and appropriately examine their causes by precisely analyzing the status of insurance sales management and assessing the effectiveness of insurance sales management, based on all information available regarding the status of insurance sales management, such as the results of audits by corporate auditors, internal audits and external audits,6 findings of various investigations and reports from various divisions? In
It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report, and shall not External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear in mind that currently, audits other than the audit of financial statements required under the rules and the verification of the internal control system conducted as part of the procedures of this audit are not obligatory. However, in the case where the inspected insurance company undergoes an external audit other than the financial statements audit in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining in a comprehensive manner along with the financial statements audit results.
addition, if necessary, does it take all possible measures to find the causes by, for example, establishing fact finding committees, etc. consisting of non-interested persons? (2) Revision of Analysis and Assessment Processes Does the Board of Directors or organization equivalent to the Board of Directors revise the analysis and assessment processes in a timely manner, by reviewing their effectiveness based on reports and findings on the status of insurance sales management in a regular and timely manner or on an as needed basis?
2) Improvement Activities
(1) Implementation of Improvements
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the insurance sales management system identified through the analysis, assessment and examination referred to in 3. 1) above in a timely and appropriate manner, based on the results obtained by developing and implementing an improvement plan as required or by other appropriate methods? (2) Progress Status of Improvement Activities Does the Board of Directors or organization equivalent to the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner, by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of Improvement Process Does the Board of Directors or organization equivalent to the Board of Directors revise the improvement process in a timely manner, by reviewing its effectiveness based on reports and findings on the status of insurance sales management in a regular and timely manner or on an as needed basis?
II. Development and Establishment of Insurance Sales Management System by Managers
Checkpoints
as “Sales Compliance related Information”).
must be obeyed, corresponding to the insurance sales operations (including specific examples of inappropriate acts which may pertain to Act Article 307, Paragraph 1, Item 3)
organization. Some large independent agencies have strong power in negotiations with insurance companies. It should be kept in mind that development of the systems and execution of specific policies as described above must also be executed solidly for these agencies (3) Collection, Management, Analysis and Study of Sales Compliance related Information Does the Manager develop the means for timely and efficient collection of Sales Compliance related Information scattered throughout various departments of the insurance company, corresponding to the characteristics of the insurance company’s operations? Does the Manager also develop a system to appropriately manage the collected Sales Compliance related Information, analyze its content, and make it useful for improvement of the insurance sales management system, including preventing the occurrence and reoccurrence of insurance sales related Legal Violations, etc.? (4) Communication and Cooperation System (i) Does the Manager communicate information and closely cooperate with divisions which have various Sales Compliance related Information, via the Manager himself or the Insurance Sales Management Division? (ii) Does the Manager cooperate as needed with the compliance officers7 assigned in each insurance sales related operating division and business location? (5) Monitoring System To ensure insurance sales related legal compliance by related operating divisions and business locations and insurance sales representatives, does the Manager develop a system to continually monitor the situation of such legal compliance in each division periodically and as needed, by the methods such as: (i) requiring each division to report on its situation of such legal compliance, (ii) continually collecting information from compliance officers, (iii) performing site inspections? (6) System for Handling Insurance Sales related Legal Violations, etc. Does the Manager develop a system so that if by analysis of Sales Compliance related Information and notices and whistleblowing from and other departments, it is judged that there are suspected insurance sales related Legal Violations, etc., then someone quickly investigates the facts, and a misconduct related notice is handled in cooperation with the Compliance Control Division (including performing investigations and verifications in appropriate departments)? Does the Manager also develop a system for response, such as incorporating the results of investigations and analysis to prevent reoccurrence? In particular, is there a system for quickly checking whether there were problems in insurance sales for contracts and matters where misconduct is typically very likely, for example by checking contracts which were quickly invalidated or quickly cancelled? (7) Management System for Displays of Insurance Sales Materials, etc.
Refer to the Checklist for Legal Compliance.
Does the Manager develop a system to check whether Insurance Sales Materials, etc. undergo prior legal checks by the Insurance Sales Management Division and product development division, whether they violate the Insurance Business Act (including mutatis mutandis parts of the Financial Instruments and Exchange Act), laws and their orders for enforcement for prohibition of private monopolies and ensuring fair trading, laws prohibiting improper gifts and improper displays, and other related laws and regulations, whether displays of content of insurance products are correct, and whether explanations to customers are full and appropriate? Also, is a system developed for central management by headquarters, for Insurance Sales Materials, etc. only used by a business location or insurance sales representative, with complete screening of their display contents? (8) Cooperation with Manager Responsible for Customer Support, etc. (i) Does the Manager cooperate appropriately with the manager responsible for customer support,8 and develop a system to quickly and broadly get information on consultations and complaints9 from customers regarding insurance sales, and on matters which should be recognized as complaints and those which could become complaints? (ii) For consultations and complaints which contain information on actual or suspected Legal Violations, etc. related to insurance sales, does the Manager develop a system to appropriately demand information reports from divisions, departments, individuals, etc. which have information, obtain, analyze and study these reports, and provide the results to the manager responsible for customer support? (iii) For cases deemed necessary among consultations and complaints about insurance sales, does the Manager develop a system to work to find the causes by having a person without conflicts of interest appropriately and fully investigate them? (9) Cooperation with Compliance Control Division Does the Manager develop a system for appropriate cooperation with the Compliance Control Division, to solve issues in compliance for insurance sales? (10) Training and Guidance System Does the Manager thoroughly inform officers and employees about the content of the Insurance Sales Compliance Manual? Also, does the Manager develop a system to provide sufficient training and guidance on matters required for proper insurance sales: laws and regulations which should be obeyed in insurance sales, knowledge about insurance contracts and insurance products, methods of using Insurance Sales Materials, etc.? (11) System Developed for New Products Does the Manager develop a system so that if a request is received from the New Products
Refer to the Checklist for Customer Protection Management.
Refer to the Checklist for Customer Protection Management.
Committee, etc. regarding New Products, etc., then the regulations and internal rules on such New Products, etc. are investigated in advance, bringing to light problems which could arise from the viewpoint of insurance sales management, which are then reported to the New Products Committee, etc., based on the New Products Management Policy and Insurance Sales Management Rules, etc.? (12) System for Reporting to the Board of Directors or Organization Equivalent to the Board of Directors Does the Manager develop a system for the Board of Directors or organization equivalent to the Board of Directors to receive reports on the report items established by the Board of Directors or organization equivalent to the Board of Directors, periodically or as needed? In particular, does the Board of Directors or organization equivalent to the Board of Directors quickly receive reports on matters which have major effects on the business, or remarkably impair customer interests? (13) System for Reporting to Corporate Auditors Does the Manager report directly to the corporate auditors, in accordance with the items determined by the Board of Directors?
3) Assessment and Improvement Activities
Does the Manager verify the effectiveness of insurance sales management systems, considering reports, investigation results and monitoring results on the status of legal compliance in insurance sales, such as the status of compliance with the Insurance Sales Compliance Manual and various related rules, periodically or as needed? Does he make timely revisions to various related rules (including the Insurance Sales Compliance Manual), the organizational framework , provision of training and guidance, monitoring methods, etc., and provide improvement recommendations as needed to the Board of Directors or organization equivalent to the Board of Directors?
departments in the insurance company? Does it manage, analyze and study this information, and based on the results, take timely and appropriate actions? In particular, does it cooperate closely with the compliance officers in related operating divisions and business locations, and collect information? (3) Monitoring of Legal Compliance in Insurance Sales From the viewpoint of thorough legal compliance in insurance sales, does the Insurance Sales Management Division continually monitor the status of legal compliance in insurance sales by related operating divisions and business locations and insurance sales representatives? For example, does it monitor periodically and as needed, by methods such as requiring compliance officers to provide reports on the status of legal compliance in insurance sales, or by continually collecting information, and performing timely on-site investigations? (4) Handling of Legal Violations, etc. in Insurance Sales (i) For matters which are suspected Legal Violations, etc. in insurance sales, does the Insurance Sales Management Division use analysis of Sales Compliance related Information and communications and whistleblowing from other departments, to immediately check the facts as to whether such acts occurred and the existence of problems, or have the facts checked by a department without conflict of interests? Does it thus verify the existence of actual Legal Violations, etc. and the existence of compliance weak points? (ii) As a result of the fact checking done in (i) above, for matters which are Legal Violations, etc. or which are judged to have a strong possibility of being Legal Violations, etc., does the Insurance Sales Management Division immediately report to the manager, and cooperate with related divisions or departments to take appropriate action, including cooperation with the Compliance Control Division on a notice as misconduct? (iii) For Legal Violations, etc. in insurance sales, does the Insurance Sales Management Division conduct a timely and appropriate investigation of its background, causes and scope of effects, or have it investigated by a department without conflicts of interest in the case. Does it then analyze this and report its results to the Manager? (iv) From the viewpoint of preventing reoccurrence, does the Insurance Sales Management Division provide the analysis results of (iii) above as feedback to managers of related operating divisions and business locations? Does it quickly take actions for future prevention, or have another division take actions? (5) Appropriate Management of Displays of Insurance Sales Materials, etc. Does the Insurance Sales Management Division appropriately conduct legal checks on Insurance Sales Materials, etc., and appropriately manage so that the display contents of all Insurance Sales Materials, etc. are exhaustively screened, including things only used by a business locations or insurance sales representatives? (6) Cooperation with Manager Responsible for
Customer Support
(i) Does the Insurance Sales Management Division appropriately cooperate with the manager responsible for customer support in the customer protection management system, and make recommendations for smooth customer support? (ii) Does the Insurance Sales Management Division quickly and broadly obtain information on consultations and complaints from customers regarding insurance sales, and on matters which should be considered complaints, and matters which could become complaints? (iii) For consultations and complaints about insurance sales which contain information on actual or suspected Legal Violations, etc., does the Insurance Sales Management Division appropriately obtain, analyze and study reports on information from divisions, departments and individuals which have information, and provide feedback to the manager responsible for customer support? (iv) Among consultations and complaints about insurance sales, for cases where it is deemed necessary, does the Insurance Sales Management Division work to find the causes by an appropriate and sufficient investigation done by a person without conflicts of interest? (7) Cooperation with Compliance Control Division To solve compliance issues in insurance sales, does the Insurance Sales Management Division cooperate appropriately with the Compliance Control Division? (8) Roles of Compliance Officers for Insurance Sales Management Do compliance officers summarize Sales Compliance related Information for the department where they are assigned, corresponding to the qualities of the operations of the departments, and communicate this to the Insurance Sales Management Division, periodically or as needed? Do they appropriately work on legal compliance in insurance sales at that department? (9) Handling of New Products When the Insurance Sales Management Division handles New Products, etc., does it investigate in advance the regulations and internal rules concerning those New Products, etc., and bring to light possible problems from the viewpoint of insurance sales management? In doing these investigations, is there no improper interference from the Marketing and Sales Division? Does the division also develop a system for working on appropriate handling of customers during insurance sales. For example, does it appropriately create and check sales materials for products being sold?
Checkpoints
various documents which must be provided for customer protection, corresponding to the insurance product, including the following items?
which emphasizes guarantee details. In such a case, one must consider that this could create the misunderstanding that this insurance product’s content is remarkably more advantageous than the actual product.
are displays for sales of variable insurance and market value adjustment (MVA) insurance, are actions taken to have the customer sufficiently understand special aspects of the insurance mechanism: that the insurance amount or cancellation repayment varies depending on the asset investment results or market interest rates. Moreover, if there are displays regarding sales of foreign currency denominated insurance, are actions taken to help customers to sufficiently understand the existence of currency risks? (6) Proper Sales Clerical Management (i) Are appropriate guidance and management provided for insurance sales representatives regarding sales clerical work? Is guidance and management provided for the following issues? Especially for non-life insurance agencies, are documents prepared and stored which show insurance premiums received clearly separated from the agency’s own assets, and clearly stating revenues and expenses? After insurance are premiums received, are they remitted to the insurance company without delay? Or are they placed in a separate dedicated deposit account, and settled at the latest the month after the month the insurance contract was posted in the insurance company? (ii) Are internal audits regarding sales clerical work done appropriately with sufficient frequency? (iii) Is a system developed for proper delivery, collection and storage of the first insurance premium allocation receipt? (iv) For the contract for collection of the second and later insurance premiums, is a system developed for proper management of collection card receipts, collection slips, receipts, etc., and management of unpaid contracts? (v) Are actions taken to prevent mismatched cash balances? (vi) Is a system developed to ensure proper contents of advanced payments, temporary payments and loans for insurance sales representatives? (vii) Is a system developed to ensure appropriate payment of sales expenses, etc.? (vii) Are identification documents properly provided and retrieved? (ix) Is other clerical management done properly? For example, are there efforts to avoid and correct the following points? a. Insurance premium receipts, certificate of automobile liability insurance, payment received seal of automobile liability insurance, insurance sticker of automobile liability insurance
b. Policyholders loan related
there a system for the Marketing and Sales Division, etc. to understand and inspect the agencies’ daily operations? For example, is a system developed for the Marketing and Sales Division, etc. to gain timely understanding of the status of supervision, operations audit, training and monitoring of insurance sales representatives by agencies? b. With awareness of the necessity and importance that agencies build sales systems with their own responsibility, is a system developed for appropriate legal and regulatory compliance and customer protection in insurance sales by agencies? For example, is the method used corresponding to the agency’s size and characteristics, wherein the agency itself assigns a person in charge of insurance sales management in the agency, and cooperates with the person in charge of insurance sales management in various business locations?
c. In response to customer inquiries, complaints and consultations about contract contents
and various procedures, the insurance company must handle these quickly as needed, in close cooperation with the agency. Is a system to do this developed in the insurance company, and are agencies also instructed to developed this? d. When an insurance company outsources its insurance sales support and guidance for agencies to another insurance company, does it ensure that such other insurance company thoroughly implements the insurance sales management? (iv) Are actions taken to prevent acts which invite harm by excessive competition, such as excessive advantages given to a specific agency? (9) Agency and Management of Insurance Sales in the Case of Banks When insurance sales are outsourced to banks, etc., does the insurance company establish appropriate policy, and are outsourcing details determined based on that policy, from the viewpoints of ensuring sound and appropriate management of that operation and fairness of insurance sales? Also, is a system developed to appropriately supervise, audit operations, provide training, and do monitoring at banks, etc., based on the laws and regulations on insurance sales by banks, etc., and considering the characteristics of insurance sales operations of banks, etc.?
2. Life Insurance related Problems
(1) Application of Exception from Serving Only One Company For a life insurance sales representative affiliated to two or more entrusting insurance companies (Article 282, Paragraph 3 of the Act), is it checked whether actions are taken to prevent improper sales of transfers between the insurance companies served, management of customer information, etc.? (2) Group Contracts, Collective Contracts, Group Insurance (i) Does it have an appropriate aspect as a group? Does it fall into a defined group
demarcation?
(ii) Are the insured amount, number of insured persons, and contract (agreement) details appropriate? (iii) Are the insurance premiums and collection fees appropriate? (iv) Are actions taken to prevent so-called non-member contracts? (v) In response to changes in the group’s characteristics, is there a system to revise insurance premiums appropriately? (3) Insurance Contracts on Lives of Others (i) For insurance contracts on the life of another person and life insurance contracts with a minor as the insured person, from the viewpoint of working to protect the insured person by preventing misuse of the insurance contract, are there initiatives to work for an insurance contract in accordance with the aims and intentions? For example, are the following initiatives taken?
pensions?
For example, are the following acts not occurring?
to not make insurance sales such as own contracts which aim at insurance premium discounts or rebates, etc.? (ii) For a life insurance sales representative which is a corporation, if the insurance policyholder is that life insurance salesperson or a corporation which has a close relationship with that life insurance sales representative, are actions taken such as guidance and management to not make insurance sales which aim at discounts or rebates by fee payments etc.?
3. Non-life Insurance related Problems
(1) Group Contracts, Collective Contracts, Group Insurance (i) Does it have an appropriate aspect as a group? Does it fall into a defined group demarcation? (ii) Are the insured amount, number of contracts, and contract (agreement) details appropriate? (iii) Are the insurance premiums and collection fees appropriate? (iv) Are actions taken to prevent so-called non-member contracts? (v) In response to changes in the group’s characteristics, is there a system to revise insurance premiums appropriately? (2) Self-Contracts, etc. (i) Are appropriate actions taken to prevent violations of the Prohibition of Self-Contract (Insurance Business Act, Article 295)? (ii) Is a system developed for understanding the situations of self-contracts of affiliated agencies, providing strict management and guidance, so there is proper calculation of insurance premiums for self-contracts? (iii) Are contracts made with another agency instead, to evade the prohibition of self-contract? Are actions taken to prevent such evasion? (3) Coinsurance Contracts In the case of coinsurance contracts and joint sales of insurance products, are actions taken to avoid creating misunderstandings among policyholders about the insurance type and underwriting company? (4) Excessive Insurance (Setting an Insurance Amount which is Excessive for the Insurance Price) To prevent excessive insurance contracts, are items which should be confirmed specified, and other procedures and a framework developed? (5) After Loss Contracts (Insurance Contracts Signed After the Insured Accident Occurred) To prevent after loss contracts, are items which should be confirmed specified, and other procedures and a framework developed? (6) Third-Sector Insurance If third-sector insurance is handled, for sales of insurance of persons, from the viewpoint of
ensuring the appropriateness of insurance sales, is sufficient guidance provided to insurance sales representatives? (7) Replacement Contracts and Conversion Contracts Are long term insurance contracts such as medical insurance handled according to 2.(6) above? (8) Insurance Contracts on Lives of Others (i) For insurance contracts on the life of another person and death benefit insurance contracts with a minor as the insured person, from the viewpoint of protecting the insured person by preventing misuse of the insurance contract, are there initiatives to work for an insurance contract in accordance with the aims and intentions? For example, are the following initiatives taken?
(Reference: Checklist of Insurance Brokers)
1) The following are shown as examples of unique items for insurance brokers, for use when an
inspector inspects an insurance broker (inspection based on Article 305 of the Act). In inspections of insurance brokers, one must keep in mind that the insurance broker is not under the guidance and supervision of an insurance company.
2) When using this checklist in an examination of a specific case, one must keep in mind that it must
be based on provisions of the Insurance Business Act, other related laws and regulations, and supervisory guidelines. Examples of Check Items for Business Operations of Insurance Brokers
1) Appropriateness of Operations
(1) Is the insurance broker conducting business other than intermediation of signing insurance contracts as established in laws and regulations? (2) For agency or intermediary in signing insurance contracts, does the insurance broker outsource this to an insurance company, its officers, life insurance sales representatives, non-life insurance sales representatives or another insurance broker (“life insurance sales representatives, non-life insurance sales representatives and another insurance brokers” are referred to collectively as “Other Insurance sales representatives, etc.” Same hereinafter.)? (3) For agency or intermediation in signing insurance contracts, does the insurance broker receive work outsourced from Other Insurance sales representatives, etc.? (4) For agency or intermediary in signing insurance contracts, does the insurance broker receive work outsourced from an insurance company or its officers? (5) Does the insurance broker have signing of self-contracts as a main business? (6) Does the insurance broker, provide to Other Insurance sales representatives, etc. the customer’s undisclosed information without consent? Especially if sharing computers with insurance sales representative with which there is a certain capital relationship, are there appropriate information firewalls? (7) Does the insurance broker have its office for agency or intermediary in signing insurance contracts in the same building as the office of an Other Insurance Sales Representatives, etc.? If it is in the same building, are sufficient actions taken to avoid creating misunderstanding among customers? For example, is its sole use area independently separate, with shared area from the entrance until the various offices, which is then divided up? (8) Does the insurance broker or its officers or employees perform acts which pertain to prohibited acts specified in the Act, Article 300, Paragraph 1, each item? (9) Does the insurance broker perform acts which pertain to an “extremely inappropriate act in soliciting insurance” as provided in Article 307, Paragraph 1, Item 3 of the Act, or other
violations of laws or regulations?
2) Delivery of Signed Contract
Does the insurance broker appropriately prepare and deliver signed contracts?
3) Ensuring agency or intermediary for signing insurance contracts from a standpoint which is
independent from insurance companies
(1) Does the insurance broker have its office for agency or intermediary in signing insurance contracts in the same building as the office of an insurance company? If it is in the same building, are sufficient actions taken to avoid creating misunderstanding among customers? For example, is its sole use area independently separate, with shared area from the entrance until the various offices, which is then divided up? (2) Does the insurance broker receive capital invested from an insurance company? If it receives capital invested, are there grounds for performing on its good faith obligations, and for proper capital investment? (3) Does the insurance broker receive transfers of officers from an insurance company, or transfer its officers to an insurance company?
4) Performing on Good Faith Obligations to Customers
(1) Does it check the customer’s guarantee needs, cost burden capacity for insurance premiums, etc., and recommend something which is optimal for the customer? (2) Does it appropriately communicate information on insurance? Does it appropriately communicate requests from customers and other information to insurance companies? (3) Does it comply with its confidentiality obligation? (4) Are insurance premiums deposited by customers appropriately managed and remitted to insurance companies?
5) Disclosure of Disclosure Items
Is prior disclosure to customers done appropriately? In particular, is there clear indication for items the broker is obligated to indicate clearly (Article 296 of the Act), and disclosure when disclosure is required (Article 297 of the Act)?
6) Customer Support Management
Considering the insurance broker’s size and characteristics, is a customer support management system developed? For examinations, refer to the Checklist for Customer Protection Management.
Checklist for Customer Protection Management
I. Development and Establishment of Customer Protection Management System by the
Management
Checkpoints
In cases where insurance sales business is outsourced to an agency, in principle, it is not subject to this checklist, unless written in the Checklist for Insurance Sales Management, and agencies are especially noted as being subject to the checklist. As stipulated in Article 100-2-2 of the Act, that insurance company, a parent financial institution or subsidiary institution, etc. of that company, as well as a company for which that insurance company deems it necessary to manage conflicts of interest in order to protect customers.
their convenience but it is also extremely important from the viewpoint of ensuring the soundness and appropriateness of the company’s business. Therefore, the company’s management is charged with and responsible for taking the initiative in developing and establishing such a system.
listed in Chapter I. are absent or insufficient, thus causing the said problem, and review findings thereof through dialogue between the inspector and the insurance company.
referred to as the “Customer Support”)
3 The Customer Protection Management Rules may not be available as a single set of rules in some cases, and they may be integrated with the compliance manual, etc. in other cases. The inspector should empirically review, regardless of the form of rules, whether or not the rules exhaustively stipulate necessary matters and are fully disseminated to personnel who should be acquainted with them, upon approval by the Board of Directors, thus ensuring an effective system of Customer Protection.
Protection Management Policy after legal checks, etc.?
(2) Develop Systems of Contract Management Division and Payment Management Division Contract Management Division as the division which manages clerical work concerning insurance contract management, and establish a Payment Management Division as the division which controls overall clerical work concerning Payment of Insurance Claims, etc., in accordance with the Customer Protection Management Policy and Customer Protection Management Rules?4 (ii) Does the Board of Directors assign Managers who have the knowledge and experience required to control the Contract Management Division and the Payment Management Division? Does the Board grant to each of these Managers the authority required to execute management operations? (iii) Does the Board of Directors or organization equivalent to the Board of Directors assign to the Contract Management Division and Payment Management Division an appropriate number of staff who have the knowledge and experience required to execute the operations each are in charge of, and grant each staff the authority required to execute their work?5 Are staff and authority assigned while fully taking into account that insurance company’s size and characteristics, such as products handled, target markets and main sales channels? Especially for the Payment Management Division, considering the specialization of its operations, it is desirable to have assignments with consideration of fostering managers from the viewpoint of long term human resource development. (iv) Does the Board of Directors or organization equivalent to the Board of Directors develop a system for wielding a check and balance function, by ensuring that the Contract Management Division and Payment Management Division are independent from the Marketing and Sales Division? Especially if the Contract Management Division and Payment Management Division are also in charge of other businesses, is consideration given to a system for preventing interference by the Marketing and Sales Division? (3) Assignment of Responsible Managers, Granting Them Authority, and Ensuring a Check
When the contract management division or payment management division are not established as an independent division (e.g., when the division is consolidated with another division to form a single division, or when a division in charge of other business manages control of management of clerical work concerning insurance contract management and overall clerical work concerning Payment of Insurance Claims, or when a Manager or Managers take charge of such management and control instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division commensurate with the scales and natures of the insurance company. When a department or a post other than the Board of Directors or organization equivalent to the Board of Directors is empowered to allocate staff and assign them authority, the inspector shall review, in light of the nature of such a department or post, whether or not this is reasonable in terms of a check-andbalance system and other aspects.
and Balance Function, for Customer Support Management, Customer Information Management, Outsourcing Management and Conflict of Interest Management (i) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to have the Managers specified below appointed, stipulated the responsibilities and authority of the Managers and allocated appropriate roles to them in accordance with the Customer Protection Management Policy and the Customer Protection Management Rules? Do the Managers have sufficient knowledge and experience for the business they are in charge?6
6 When the Manager in charge of one of the operations concerning Customer Protection concurrently serves as the Manager in charge of another such business or in a post (including the Manager post) at a division not related to Customer Protection, the inspector should pay attention to whether such a system is reasonable in light of the scales and natures of the business operations concerned and whether an equivalent level of Customer Protection functions is secured compared with the case where a dedicated Manager is appointed. With regard to Customer Support, for example, two or more Customer Support Managers may be appointed. In such a case, the inspector should review whether the areas of responsibility are clearly defined with methods such as having the Managers jointly bear the responsibility for the overall customer management business operation or having one of the Managers bear this responsibility.
(i) Does the Board of Directors or organization equivalent to the Board of Directors provide a system, via the Managers or divisions in charge or responsible Managers, to ensure effectiveness of Customer Protection Management, for example by disseminating internal rules and operational procedures to the divisions, departments and employees whose operations require Customer Protection Management, including the Marketing and Sales Division, etc., and having them observe the rules and procedures? For example, does the Board of Directors or organization equivalent to the Board of Directors instruct the Managers or divisions in charge or responsible managers to take concrete measures such as specifying the internal rules and operational procedures that must be observed by the Marketing and Sales Division, etc. and conducting effective training on a regular basis? Especially for agencies or other external insurance sales representatives and the organizations to which they belong, is a system developed to have them comply with internal rules and operational procedures, with a system for understanding the compliance situation? (ii) Does the Board of Directors or organization equivalent to the Board of Directors assign a person in charge of managing customer information at each division and department and specify the responsibilities and authority thereof? Does the person have sufficient knowledge and experience for the relevant business? (iii) Does the Board of Directors or organization equivalent to the Board of Directors appropriately set up contact points which are easy for customers to access? (5) Ensuring Customer Information Protection at Outsourcing Contractors and Agencies (i) Has the Board of Directors or organization equivalent to the Board of Directors clearly specified the rules concerning the handling of customer information by outsourcing contractors operating under outsourcing contracts (hereinafter referred to as the “Outsourcing Contractors”) and agencies in a manner suited to the nature and quantity of the customer information handled? (ii) Has the Board of Directors or organization equivalent to the Board of Directors specified the department that is responsible for supervising the Outsourcing Contractor and the agency, and assigned a person in charge of managing customer information to the department? (iii) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure verification of Customer Information Management at the Outsourcing Contractor and the agency on a regular basis? (iv) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure that measures for protecting customer information are appropriately disseminated to the Outsourcing Contractor and the agency, and that accidents, etc. at the Outsourcing Contractor and the agency are reported to the department in charge promptly and accurately?
(6) Arrangement for System of Reporting to Board of Directors and Approval Has the Board of Directors or organization equivalent to the Board of Directors appropriately specified matters to be reported and approved and does it have the Manager of the division charge or the responsible Manager report the current status to the Board of Directors or organization equivalent to the Board of Directors or have the Manager seek the approval of the Board of Directors or organization equivalent to the Board of Directors on the relevant matters in a regular and timely manner or on an as needed basis? In particular, does it ensure that the Manager reports to the Board of Directors or organization equivalent to the Board of Directors any matters that would seriously affect corporate management or significantly undermine customer interests without delay? (7) Arrangement for System of Reporting to Corporate Auditor In the case where the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately and do they provide a system to ensure that the Manager of the division in charge or the responsible manager report directly to the auditor? 7 (8) Development of Internal Audit Guidelines and an Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or the manager of the Internal Audit Division appropriately identify the matters to be audited with regard to Customer Protection, develop guidelines that specify the matters subject to internal audit procedures (hereinafter referred to as the “Internal Audit Guidelines”) and internal audit plan, and approve them?8 (9) Revision of Development Process of Internal Rules and Organizational Frameworks Does the Board of Directors or organization equivalent to the Board of Directors revise the development process of internal rules and organizational frameworks in a timely manner by reviewing their effectiveness based on reports and findings on the status of Customer Protection Management in a regular and timely manner or on an as needed basis?
3. Assessment and Improvement Activities
1) Analysis and Assessment
(1) Analysis and Assessment of Customer Protection Management Does the Board of Directors or organization equivalent to the Board of Directors appropriately determine whether there are any weaknesses or problems in the Customer Protection Management system and the particulars thereof, and appropriately examine their causes by
7 It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report and shall not restrict the authority and activities of the auditor in any way. 8 The Board of Directors or organization equivalent to the Board of Directors only needs to have approved the basic matters with regard to an internal audit plan.
precisely analyzing the status of Customer Protection Management and assessing the effectiveness of Customer Protection Management, based on all of the information available regarding the status of Customer Protection Management, such as the results of audits by corporate auditors, internal audits and external audits,9 findings of various investigations and reports from various divisions? In addition, if necessary, does it take all possible measures to find the causes by, for example, establishing fact findings committees, etc. consisting of noninterested persons? (2) Revision of the Analysis and Assessment Processes Does the Board of Directors or organization equivalent to the Board of Directors revise the analysis and assessment processes in a timely manner by reviewing their effectiveness based on reports and findings on the status of Customer Protection Management in a regular and timely manner or on an as needed basis?
2) Improvement Activities
(1) Implementation of Improvements
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the Customer Protection Management system identified through the analysis, assessment and examination referred to in 3. 1) above in a timely and appropriate manner based on the results obtained by developing and implementing an improvement plan as required or by other appropriate methods? (2) Progress Status of Improvement Activities Does the Board of Directors or organization equivalent to the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of the Improvement Process Does the Board of Directors or organization equivalent to the Board of Directors revise the improvement process in a timely manner by reviewing its effectiveness based on reports and findings on the status of Customer Protection Management in a regular and timely manner or on an as needed basis?
External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear in mind that currently, audits other than the audit of financial statements required under the rules and the verification of the effectiveness of the internal control system conducted as part of the procedures of this audit are not obligatory. However, in the case where the inspected insurance company undergoes an external audit other than the financial statements audit in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining in a comprehensive manner along with the financial statements audit results.
II. Development and Establishment of Customer Protection Management System by Managers
Checkpoints
Insurance Contract Management Manual10 a. Does the Manager fully recognize the necessity and importance of ensuring fast and appropriate Insurance Contract Management? b. Does the Manager create internal rules (hereinafter referred to as the “Insurance Contract Management Rules”) which clearly establish arrangements to ensure fast and appropriate Insurance Contract Management, in accordance with the Customer Protection Management Policy?
c. Does the Manager create operational procedures which clearly establish procedures which
must be followed in Insurance Contract Management (hereinafter referred to as the “Insurance Contract Management Manual), in accordance with Customer Protection Management Policy and Insurance Contract Management Rules? d. Is the organization informed about the Insurance Contract Management Rules, after they pass through a legal check, and receive approval by the Board of Directors or an organization equivalent to the Board of Directors? (ii) Insurance Contract Management Rules Do the Insurance Contract Management Rules appropriately and comprehensively stipulate arrangements necessary to ensure fast and appropriate Insurance Contract Management, corresponding to the size and characteristics of the operation? Are they appropriate? For example, are there clearly written arrangements concerning the following items?
10 Note that the Insurance Contract Management Rules and Insurance Contract Management Manual are not necessarily separate. Depending on the insurance company, they can be combined with the compliance manual, etc. Regardless of the form, verify that items which should be written are all clearly documented, that people who need to be are thoroughly informed, and that this is appropriately managed.
contract changes, cancellations, invalidation management, recovery, contract renewal, etc.
the status of compliance with the Insurance Contract Management Manual?
(vi) System Developed for New Products, etc.
Does the Manager develop a system so that if a request is received from the New Products Committee, etc. regarding New Products, etc., then the regulations and internal rules on such New Products, etc. are investigated in advance, bringing to light problems which could arise from the viewpoint of Customer Protection, which are then reported to the New Products Committee, etc., based on the New Products Management Policy and Insurance Contract Management Rules, etc.? (vii) System for Reporting to Board of Directors or Organization Equivalent to the Board of Directors Does the Manager provide a system to report matters determined as necessary by the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner or on an as needed basis? In particular, does the Manager report to the Board of Directors or organization equivalent to the Board of Directors without delay, on any matter that would seriously affect corporate management or significantly undermine customer interests? (viii) System for Reporting to Corporate Auditor Does the Manager report matters specified by the Board of Directors directly to a corporate auditor? (3) Assessment and Improvement Activities Does the Manager review the effectiveness of Insurance Contract Management System in a regular and timely manner or on an as needed basis, based on the reports and the results of investigations concerning the status of Insurance Contract Management, such as the status of compliance with the Insurance Contract Management Rules and Insurance Contract Management Manual, as well as based on the results of monitoring? Does the Manager revise in a timely manner the content of the Insurance Contract Management Rules and Insurance Contract Management Manual, the organizational framework, the implementation of training and guidance and the method of monitoring, and present the Board of Directors or organization equivalent to the Board of Directors with proposals for improvement as necessary by examining effectiveness of the Insurance Contract Management system?
2) Roles and Responsibilities of Contract Management Division
(1) Execution of Specific Policies concerning Insurance Contract Management Does the Contract Management Division manage appropriately? For example, does it instruct the related operating divisions and business locations to take specific actions to ensure fast and appropriate Insurance Contract Management? Does it provide guidance and supervision so there is appropriate Insurance Contract Management in each department? (2) Communication and Cooperation (i) Does the Contract Management Division quickly report to the Compliance Control Division, regarding problems in compliance found in execution of clerical work concerning Insurance Contract Management? (ii) Does the Contract Management Division make revisions and improvements as necessary, for problems such as misconduct incidents, complaints and inquiries, which are found as a result of internal audits in cooperation with the Internal Audit Division, Compliance Control Division and Customer Support Manager? (3) Monitoring of Insurance Contract Management From the viewpoint of ensuring fast and appropriate Insurance Contract Management, does the Contract Management Division continually monitor the status of compliance with the Insurance Contract Management Manual at related operating divisions and business locations? (4) Handling of New Products, etc. If New Products, etc. are handled, does the Contract Management Division do prior investigations of regulations, internal rules, etc. concerning those New Products, etc., and bring to light problems which could arise from the viewpoint of Insurance Contract Management? Are such investigations done without improper influence by the Marketing and Sales Division? Also, is a system developed which works for appropriate handling of the customer when an insurance contract is signed? For example, is a system developed to perform contract data management?
11 Note that the Insurance Claims Payment Management Rules and Insurance Claims Payment Management Manual are not necessarily separate. Depending on the insurance company, they can be combined with the compliance manual, etc. Regardless of the form, verify that items which should be written are all clearly documented, that people who need to be are thoroughly informed, and that this is appropriately managed.
undermine insurance policyholder interests?
It is desirable to provide sufficient disclosure of the approach and representative cases for application of reasons for non-payment or cancellation, for the interests of insurance policyholders. (ii) Insurance Claims Payment Management Rules Do the Insurance Claims Payment Management Rules specify complete and appropriate arrangements to ensure fast and appropriate insurance claims payment management, corresponding to the size and characteristics of operations? Are they appropriate? For example, are the following arrangements clearly written?
Roles, responsibilities and organization of the Payment Management Division
Coordination and mutual checks between payment divisions, to prevent overlooked
payments
Re-examination or post-review of the validity of assessment results
Monitoring of the status of insurance claims payment management
Storage of records of processing of insurance claims payment management
Approval and screening of New Products, etc.
Reports to the Board of Directors or organization equivalent to the Board of Directors
Cooperation and communication with the Compliance Control Division, Insurance Sales
Management Division, Customer Support Manager, etc.
(iii) Insurance Claims Payment Management Manual Does the Insurance Claims Payment Management Manual stipulate comprehensively, in detail, and simply the specific procedures for Insurance Contract Payment Management, corresponding to the content and methods of operations run by the insurance company? Is its content appropriate, for example clearly writing the following points?
Procedures for insurance claim payment management clerical work, such as reception of
insurance claims, investigation of items which require confirmation, decisions on whether to pay the insurance claims, and payments
Items which should be confirmed in investigations, and confirmation methods
Payment assessment criteria
Criteria for adding overdue interest fees
Identification of matters subject to notices, communications, guidance, explanations, etc.
which should be provided to customers, in procedures for insurance claims payment management. Also their methods and content.
Methods and content of handling and replies in response to inquiries, consultations and
requests (including requests for rechecking and reassessment of facts) which could be received from customers regarding insurance claims payment management
Prohibited acts related to laws, regulations and customer protection, etc. (for example,
illegal privacy violations in investigations, and improper payment delays)
Procedures for coordination and mutual checking among payment divisions
Procedures for communication with the Compliance Control Division, Insurance Sales
Management Division, Customer Support Manager, etc.
(2) Development of System
(i) Development of System of Payment Management Division by Manager a. Based on Customer Protection Management Policy and Insurance Claims Payment Management Rules, does the Manager develop the system of the Payment Management Division to enable fast and appropriate insurance claims payment management, and take actions to wield a checks and balances function? b. In order to enhance the payment assessment related abilities and knowledge of payment assessment staff, does the Manager develop a training and education system, for example on medical knowledge, clauses, and legal knowledge such about legal cases? Does the Manager foster human resources with expertise, based on a long term perspective? (ii) Development of System for Insurance Claims Payment Management in Related Operating Divisions and Business Locations Does the Manager have people who perform insurance claims payment management in related operating divisions and business locations comply with the Insurance Claims Payment Management Rules, Insurance Claims Payment Management Manual and other arrangements on insurance claims payment management? Does he develop a system for fast and appropriate insurance claims payment management, and take specific actions to ensure its effectiveness? (iii) Guidance and Supervision System Does the Manager develop a system to provide appropriate and sufficient guidance and supervision for related operating divisions and business locations, to enable timely and appropriate execution of payment management clerical work? (iv) Communication and Coordination System a. Does the Manager provide a system to quickly report to the Compliance Control Division on problems regarding compliance found in execution of payment management clerical work? b. Does the Manager provide a system in which, if part or all of the Payment of an Insurance Claim, etc. is rejected, then the manner of solicitation during the insurance sale is examined in cooperation with the Insurance Sales Management Division, except for cases where this is clearly not needed?
(v) Monitoring System concerning Insurance Claims Payment Management In order to ensure fast and appropriate insurance claims payment management in related operating divisions and business locations, does the Manager provide a system to continually monitor the status of compliance with the Insurance Claims Payment Management Manual? (vi) System Developed for New Products, etc. Does the Manager provide a system so that if a request is received from the New Products Committee, etc. regarding New Products, etc., then the regulations and internal rules on such New Products, etc. are investigated in advance, bringing to light problems which could arise from the viewpoint of customer protection, etc., which are then reported to the New Products Committee, etc., based on the New Products Management Policy? (vii) System of Reporting to Board of Directors or Organization Equivalent to the Board of Directors Does the Manager provide a system to report matters determined as necessary by the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner or on an as needed basis? In particular, does the Manager report to the Board of Directors or organization equivalent to the Board of Directors without delay any matter that would seriously affect corporate management or significantly undermine customer interests? (viii) System for Reporting to Corporate Auditor Does the Manager report matters specified by the Board of Directors directly to a corporate auditor? (3) Assessment and Improvement Activities Does the Manager review the effectiveness of the insurance claims payment management system in a regular and timely manner or on an as needed basis based on reports and findings on the status of insurance claims management, including the status of compliance with the Insurance Claims Payment Management Rules and Insurance Claims Payment Management Manual, as well as based on the results of monitoring? Does the Manager present the Board of Directors or organization equivalent to the Board of Directors with proposals for improvement as necessary, by revising in a timely manner the contents of the Insurance Claims Payment Management Rules and Insurance Claims Payment Management Manual, the organizational framework, the implementation of training and guidance and the method of monitoring?
2) Roles and Responsibilities of Payment Management Division
(1) Execution of Specific Policies concerning Insurance Claims Payment Management Does the Payment Management Division manage appropriately? For example, does it instruct the related operating divisions and business locations to take specific actions to
ensure fast and appropriate insurance claims payment management? Does it provide guidance and supervision so there is appropriate insurance claims payment management in each department? (2) Communication and Cooperation (i) Does the Payment Management Division quickly report to the Compliance Control Division, regarding problems in compliance found in execution of insurance claims payment management clerical work? (ii) If part or all of the Payment of an Insurance Claim, etc. is rejected, then in cooperation with the Insurance Sales Management Division, does the Payment Management Division examine the manner of solicitation during the insurance sale, except for cases where this is clearly not needed? (iii) Does the Payment Management Division make revisions and improvements as necessary, for problems such as misconduct incidents, Consultation Requests, Complaints, etc. which are found as a result of internal audits in cooperation with the Internal Audit Division, Compliance Control Division and Customer Support Manager? (3) Monitoring of Insurance Claims Payment Management From the viewpoint of ensuring fast and appropriate insurance claims payment management, does the Payment Management Division continually monitor the status of compliance with the Insurance Claims Payment Management Manual at related operating divisions and business locations? (4) Handling of New Products, etc. If New Products, etc. are handled, does the Payment Management Division do prior investigations of regulations, internal rules, etc. concerning those New Products, etc., and bring to light problems which could arise from the viewpoint of insurance payment claims management? Are such investigations done without improper influence by the Marketing and Sales Division? Also, is a system provided to work for appropriate handling of customers when Insurance Claims, etc. are paid?
12 It should be noted that the Customer Support Management Rules and the Customer Support Manual should not necessarily be compiled separately. At some insurance companies, such rules and manuals are integrated into the compliance manual. The inspector shall verify, regardless of the form of rules, whether or not the rules exhaustively stipulate necessary matters and are disseminated throughout all persons who should be acquainted with them, thus ensuring effective management.
suspected to be a violation of Laws.
2) Implementation of Customer Support
(1) Development of Management System for Customer Support (i) Does the Customer Support Management Manager have the people who provide Customer Support comply with the Customer Support Management Rules, Customer Support Manual and other Customer Support related arrangements? Does the Manager develop a system in order to provide appropriate and sufficient Customer Support, and implement specific measures in order to ensure its effectiveness? (ii) In response to Consultation Requests, Complaints, etc. and customer desires, has the Customer Support Manager developed a system for introducing customers to appropriate external institutions (including external institutions the insurance company uses for the Financial ADR System. Same hereinafter.), and providing information with outlines of procedures for those external institutions? Has the Manager developed a system for appropriate cooperation with external institutions, to enable prompt complaint handling and dispute resolution? (iii) For when Consultation Requests, Complaints, etc. are received from customers, has the Customer Support Manager developed a system to provide a sufficient response, and to appropriately examine the necessity of a petition for dispute resolution procedures, instead of easily submitting a petition to an external institution, etc.? (iv) Has the Customer Support Manager developed a system for the Financial ADR System, especially regarding the following points?13 a. If there is a designated dispute resolution institution (hereinafter referred to as the “Designated ADR Institution”) (a) Is a basic contract for the execution of procedures promptly signed with the Designated ADR Institution? Also, if there was a change in the Designated ADR Institution, is the optimum policy chosen from the viewpoint of customer protection and enhancing convenience, and are necessary measures promptly taken? Moreover, is a system developed to appropriately perform the procedures execution basic contract which was signed with the Designated ADR Institution? (b) Is there appropriate publication of the trade name or name and the contact information of the Designated ADR Institution with which the procedures execution basic contract was signed? Also, is the trade name or name and the contact information of the Designated ADR Institution written on documents in which it is legally obligated to write about handling under the Financial ADR
13 When examining specific cases regarding these items, keep in mind that the examination must be based on supervisory guidelines.
System, such as warnings information and documents provided before contract signing? b. If there is no Designated ADR Institution (a) Considering the size and characteristics of the business, is one or several of the following items appropriately selected as a complaint handling measure and dispute resolution measure? Is a system developed for the selected measures to function appropriately? a. Complaint Handling Measures
(2) Enhancement of Consultation Counter Functions (i) Does the Customer Support Manager provide for measures to enhance and strengthen the handling of Consultation Requests, Complaints, etc. at counters responsible for the consultation requests, complaints? Does the Manager endeavor to receive Consultation Requests, Complaints, etc. from a wide base, for example by setting up receiving channels such as an Internet-based counter and opinion boxes through which opinions can be expressed anonymously? Does the Manager also widely disclose these initiatives, and publicize them in an easily understood manner? For example, for customers via the Internet or other sales formats which are not face-to-face, are there widely disclosed contact points and application methods which are easy for customers to access for Consultation Requests, Complaints, etc.? Are customers informed of these in an easily understood way? (ii) If a call center is established to act as a consultation counter, is sufficient care taken to ensure the allocation of persons with appropriate knowledge and experience and to fully disseminate the Customer Support Manual to the persons via training? (iii) Does the Customer Support Manager take actions to enhance and strengthen handling of Consultation Requests, Complaints, etc. at contact points which can receive Consultation Requests, Complaints, etc., corresponding to the situation of Consultation Requests, Complaints, etc. to external insurance sales representatives? Also, are dedicated contact points for receiving Consultation Requests, Complaints, etc. provided as needed, considering the size and characteristics of the insurance sales representative? (3) Appropriateness of Customer Support (i) Do officers and employees who receive Consultation Requests, Complaints, etc. appropriately respond in a timely manner in accordance with the Customer Support Manual and in coordination with relevant divisions? Do the officers and employees ensure that the occurrence of long-pending cases is prevented and any pending case is resolved promptly by managing progress toward solutions concerning Consultation Requests, Complaints, etc. in an appropriate and timely manner? (ii) Are pressures from anti-social forces under the guise of Consultation Requests, Complaints, etc. distinguished from ordinary Consultation Requests, Complaints, etc. and promptly reported to the Compliance Control Division, etc., so as to take resolute action? If necessary, is an appropriate response made in coordination with the police and other relevant organizations? (4) Recording, Storage and Reporting (i) Does the Customer Support Manager record the details of Consultation Requests, Complaints, etc. (including those received by external insurance sales representatives), including the
results of responses to them, for storage in register books, etc. and keep the records under integrated control? (ii) Does the Customer Support Manager report the details of Consultation Requests, Complaints and the results of the processing thereof in a timely manner to the Compliance Control and Insurance Sales Management and Internal Audit Divisions, etc.? In particular, does the Manager report to the Compliance Control and Insurance Sales Management and Internal Audit Divisions, etc., as well as the Board of Directors, without delay any matter that would seriously affect corporate management or significantly undermine customer interests? (5) Analysis of Causes of Consultation Requests, Complaints, etc. and Implementation of Improvement Does the Customer Support Manager analyze the details of Consultation Requests, Complaints, etc., conduct necessary investigations to grasp their causes, and, based on the results of the analysis, present the Board of Directors with proposals for improvements and ask the relevant departments to submit reports and make improvements as necessary, thus ensuring that constant efforts are made for improvements? With regard to the Consultation Requests, Complaints, etc. that are conveyed repeatedly in particular, does the Manager review them thoroughly with the possibility in mind that some kind of problem exists and take specific measures to handle such requests and complaints appropriately? (6) Monitoring of Customer Support Does the Customer Support Manager check, on an ongoing basis, whether appropriate and sufficient Customer Support is secured by monitoring the status of compliance with the Customer Support Manual and take deterrent action as necessary? When a call center is established to act as a consultation counter, does the Manager monitor the degree of congestion of calls and review whether appropriate Customer Support is provided promptly? (7) System for Reporting to Board of Directors Does the Customer Support Manager report necessary matters to the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner or on an as needed basis? In particular, does the Manager report to the Board of Directors or organization equivalent to the Board of Directors without delay any matter that would seriously affect corporate management or significantly undermine customer interests? (8) System for Reporting to Corporate Auditor Does the Customer Support Manager report matters specified by the Board of Directors directly to a corporate auditor?
3) Assessment and Improvement Activities
Does the Customer Support Manager review the effectiveness of the Customer Support Management system in a regular and timely manner or on an as needed basis based on reports and findings on the status of management of Customer Support, including the status of compliance with the Customer Support Management Rules and the Customer Support Manual as well as based on the results of monitoring? Does the Manager present the Board of Directors or organization equivalent to the Board of Directors with proposals for improvement as necessary by revising in a timely manner the contents of the Customer Support Management Rules and the Customer Support Manual, the organizational framework, the implementation of training and guidance and the method of monitoring?
when the information is taken outside.
2) Implementation of Customer Information Management
(1) Arrangement for Customer Information Management System Does the Customer Information Supervisory Manager ensure appropriate handling of customer information at divisions engaged in the relevant business as well as at business locations and proper functioning of a check-and-balance system against them by securing, through the person in charge of managing customer information, compliance with the Customer Information Management Rules and the Customer Information Management Manual, etc.? Does the Manager implement specific measures for securing the effectiveness of the arrangement? (2) Guidance and Supervision Does the Customer Information Supervisory Manager provide appropriate guidance and supervision to the divisions engaged in the relevant business as well as business locations so as to enable them to implement administrative work related to Customer Information Management in an appropriate and timely manner? (3) Handling of Computer System Does the Customer Information Supervisory Manager take the following steps through the division or the person in charge of the computer system? (i) When customer information is printed out or downloaded, does the Manager impose limitations in an appropriate manner on the nature and quantity of the data that may be printed out or downloaded according to the purpose of the use? (ii) Does the Manager limit the scope of customer information which may be accessed to a necessary minimum according to the accessing person’s corporate post and qualifications? (iii) Are customer information data stored in personal computer terminals or the host computer, etc. protected through measures such as the use of a password system for access to the customer information database, the establishment of an identification system and encoding of the data? (iv) Are necessary protection measures taken in terms of system operations with regard to exchanges of customer information data between the insurance company and the Outsourcing Contractor? (4) Status of Management of Response to Customer Information Leakage
(i) Does the Customer Information Supervisory Manager provide a system to ensure that the person in charge of Customer Information Management immediately reports to the Customer Information Supervisory Manager in the event of an information leak? (ii) Does the Customer Information Supervisory Manager provide a system to ensure that the person in charge of Customer Information Management reports to the Compliance Control Division or the Board of Directors or organization equivalent to the Board of Directors without delay in the event of an information leak in accordance with the Customer Information Management Rules? (iii) Does the Customer Information Supervisory Manager ensure the implementation of measures to prevent secondary damage from an information leak, such as reporting to the public authorities, limiting information access and providing explanations to the Customer as necessary? Does the Manager analyze the cause of a customer information leak so as to prevent its recurrence? (5) Monitoring of Status of Customer Information Management at Each Division Does the Customer Information Supervisory Manager, through the person in charge of Customer Information Management, monitor on an ongoing basis the status of compliance with the internal rules and the Customer Information Management Manual as well as the status of Customer Information Management at each division? (6) Monitoring of Status of Customer Information Management at Agencies and Outsourcing Contractor Does the Customer Information Supervisory Manager or the person in charge of Customer Information Management keep track on whether agencies and Outsourcing Contractors appropriately manage customer information and whether they take prescribed measures in the event of accidents? (7) System for Reporting to Board of Directors and Approval Does the Customer Information Supervisory Manager report necessary matters to the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner or on an as needed basis? In particular, does the Manager report to the Board of Directors or organization equivalent to the Board of Directors without delay any matter that would seriously affect corporate management or significantly undermine customer interests? (8) System for Reporting to Corporate Auditor Does the Customer Information Supervisory Manager report matters specified by the Board of Directors directly to a corporate auditor?
3) Assessment and Improvement Activities
Does the Customer Information Supervisory Manager review the effectiveness of the Customer
Information Management system in a regular and timely manner or on an as needed basis based on reports and findings on the status of Customer Information Management, including the status of compliance with the Customer Information Management Rules and Customer Information Management Manual as well as based on the results of monitoring? Does the Manager present the Board of Directors or organization equivalent to the Board of Directors with proposals for improvement as necessary by revising in a timely manner the contents of the Customer Information Management Rules and the Customer Information Management Manual, the organizational framework, the implementation of training and guidance and the method of monitoring?
measures to be taken in a manner suited to the scales and natures of the outsourced operation? (4) Monitoring of Outsourcing Contractors Does the Outsourcing Manager ensure the exercise of necessary and appropriate supervision over the Outsourcing Contractor by reviewing whether the contractor is implementing the business operation aptly in accordance with the outsourcing contract based on checks conducted on the status of the implementation of the consigned operation in a regular and timely manner or on an as needed basis and having the contractor make improvements as necessary? Does the Manager ensure that appropriate measures can be taken in a timely manner under the outsourced contract, for example by appropriately stipulating the contract provisions that concern the supervision, monitoring and reporting? (5) System for Processing of Consultation Requests, Complaints, etc. Concerning Outsourced Operations Does the Outsourcing Manager provide for measures necessary for appropriately and promptly processing the Customer’s Consultation Requests, Complaints, etc. concerning consigned operations undertaken by Outsourcing Contractors? Is there an appropriate system for the processing of Consultation Requests, Complaints, etc., such as the establishment of a direct communication channel between the Customer and the insurance company with regard to the Consultation Requests, Complaints, etc.? (6) Backup System for Outsourced Operations When the Outsourcing Contractor fails to appropriately implement the consigned operation, does the Outsourcing Manager take measures to prevent the disruption of the operation from the viewpoint of Customer Protection, such as selecting another appropriate Outsourcing Contractor and promptly transfer the operation to the alternative contractor? (7) Contract Modification and Termination Does the Outsourcing Manager provide for measures to enable prompt modification or termination of the outsourcing contract if necessary in order to secure sound and appropriate business of the insurance company and protect the Customer related to the outsourced operation? (8) Measures for Customer Information Protection Does the Outsourcing Manager provide for measures to ensure Customer Information Management at the Outsourcing Contractor and the agency? Do the outsourcing contracts and agency contracts have provisions that prohibit the use of customer information for purposes other than the prescribed ones and obligate confidentiality, for example? Does the Manager provide for measures to ensure the exercise of appropriate supervision over the Outsourcing Contractor so as to ensure appropriate handling of customer information when the handling of information concerning customers who are individuals is
outsourced?
(9) System for Reporting to Board of Directors and Approval Does the Outsourcing Manager report necessary matters to the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner or on an as needed basis? In particular, does the Manager report to the Board of Directors or organization equivalent to the Board of Directors without delay any matter that would seriously affect corporate management or significantly undermine customer interests? (10) System for Reporting to Corporate Auditor Does the Outsourcing Manager report matters specified by the Board of Directors directly to a corporate auditor?
3) Assessment and Improvement Activities
Does the Outsourcing Manager review the effectiveness of the Outsourcing Management system in a regular and timely manner or on an as needed basis based on reports and findings on the status of Outsourcing Management, including the status of compliance with the Outsourcing Rules as well as based on the results of monitoring? Does the Manager present the Board of Directors or organization equivalent to the Board of Directors with proposals for improvement as necessary by revising in a timely manner the contents of the Outsourcing Rules, the organizational framework, the implementation of training and guidance and the method of monitoring?
14 Article 53-14, Paragraph 1, Item 3 of the Enforcement Regulations.
2) Implementation of Conflict of Interest Management
(1) Development of Conflict of Interest Management (i) Does the Conflict of Interest Manager develop a system for appropriate and sufficient Conflict of Interest Management, such as compliance with Conflict of Interest Management Rules? Does the Manager implement specific measures to ensure its effectiveness? In particular, regarding conflicts of interest management, does the Manager develop a system to demonstrate a check-and-balance function, through measures including ensuring independence of the Marketing and Sales Division? (ii) For the conduct of Conflict of Interest Management, does the Conflict of Interest Manager develop a system for appropriate coordination with the Compliance Control Division, Customer Information Supervisory Manager, etc.? (2) Guidance and Supervision Does the Conflict of Interest Manager provide appropriate guidance and supervision to the divisions engaged in the relevant business as well as business locations so as to enable them to implement Conflict of Interest Management in an appropriate and timely manner? (3) Identification of Transactions with Possible Conflicts of Interest Does the Conflict of Interest Manager develop a system to appropriately identify transactions with possible conflicts of interest? (4) Methods of Conflict of Interest Management Does the Conflict of Interest Manager develop a system for ensuring appropriate and sufficient Conflict of Interest Management, for example by the following kinds of methods, or by combining the following kinds of methods?
necessary?
(7) System for Reporting to Board of Directors Does the Conflict of Interest Manager report necessary matters to the Board of Directors or organization equivalent to the Board of Directors, in a regular and timely manner or on an as needed basis? In particular, does the Manager report to the Board of Directors or organization equivalent to the Board of Directors without delay any matter that would seriously affect corporate management or significantly undermine customer interests? (8) System for Reporting to Corporate Auditor Does the Conflict of Interest Manager report matters specified by the Board of Directors directly to a corporate auditor?
3) Assessment and Improvement Activities
Does the Conflict of Interest Manager review the effectiveness of the Conflict of Interest Management system in a regular and timely manner or on an as needed basis, based on reports and findings on the status of Conflict of Interest Management, including the status of compliance with the Conflict of Interest Management Rules as well as based on the results of monitoring? Does the Manager present the Board of Directors or organization equivalent to the Board of Directors with proposals for improvement as necessary, by revising in a timely manner the contents of the Conflict of Interest Management Rules, the organizational framework, the implementation of training and guidance, and the method of monitoring, etc.?
Checkpoints
Also, is a system provided for appropriately handling customers from the time from when the insurance is sold until payment? Moreover, does the division in charge or the responsible manager provide an appropriate IT system as needed?
2. Insurance Contract Management System
(1) Management of processing contract changes
Is a management system in place under which changes in terms and conditions of a policy are processed in an appropriate manner? (2) Early cancellations, etc. Is a system in place under which the manner in which insurance sales were conducted, the process of insurance sales, and explanations given to policyholders, etc., are reported in a timely manner to the Insurance Sales Management Division with respect to early cancellation and other policies that are questionable in terms of fair insurance sales? In these cases, for example, are the actions of insurance sales representatives confirmed concerning the following points?
(ii) Is a system in place under which a notice to policyholders is provided prior to the lapse of policies? (iii) Is a system in place under which the procedures for reinstatement of lapsed policies can be followed in an appropriate manner? (iv) Are measures taken to fully explain to policyholders the information concerning reinstatement and surrender value of lapsed policies (reinstatement procedures, whether surrender value will be payable or not, surrender value amount, when negative prescription takes effect, etc.)? (v) Is a system in place under which a notice is provided to policyholders in an appropriate manner of when negative prescription will take effect? (vi) Is a system in place under which consistent processing of negative prescription is performed after negative prescription has taken effect? Is a system in place under which a good faith response is provided to inquiries that are received after negative prescription has taken effect? (vii) Is a system in place under which sales representatives, etc., explain to a client that policies can be reinstated when recommending new policies? (5) Reporting of investment performance, etc. Is a system provided to have investment performance and other necessary matters reported periodically to policyholders of variable insurance and other products? (6) Renewal of policies (i) Is the renewal of policies at maturity managed in an appropriate manner? For example, is a system in place for preventing failures to renew policies at maturity by providing adequate advance notice to policyholders concerning renewal? (ii) Are measures taken to prevent overinsurance (setting a coverage amount in excess of an insured value), for example, by encouraging a revision of the coverage amount at the time of policy renewal? (7) Insurance certificates (i) Are the procedures and the custody methods concerning long-term custody of insurance certificates developed in an appropriate manner? (ii) Are the procedures developed for prompt and appropriate re-issuance of insurance certificates? (8) Change of address and contact information Are company addresses in contracts updated and communicated to policyholders so that policyholders can promptly inform or notify the insurance company of the customer’s address or contact information upon change of address, etc.? Is a system in place so that when the
contact information of policyholders becomes unknown, an investigation is conducted to the extent possible?
3. Management System for Payment of Insurance Claims, etc.
1) Receiving Claims Filed for Insurance Benefits
(1) Explanations and Guidance on Insurance Claims (i) To avoid lack of insurance claim filings in cases in which a suitable payment cause occurred, is a system in place for full and easily understood explanations to policyholders, regarding the procedures for filing insurance claims? (ii) Considering that products are becoming more diverse, does the Payment Management Division make timely and appropriate revisions to forms such as for documents given to the policyholder as guidance on the insurance claims procedure, to prevent a lack of insurance claims and to make sure they are easily understood? (2) Provision of Procedure for Claims Filing by Representative For cases in which a beneficiary cannot file an insurance claim, does the Payment Management Division provide a procedure which enables a representative to file the claim? (3) Process After Receiving Claim After receiving an insurance claim filed by a policyholder, is the reason for insurance payment studied fairly and equitably? If this results in an investigation which requires a significant time period, is there a system provided to inform the policyholder?
2) Investigation and Confirmation of Facts Concerning Insured Events and Damages
(1) Investigation of facts concerning insured events (i) Is there a system in place for conducting investigations of facts (including examinations after the payment of benefits) in a fair and equitable manner, regardless of whether the facts may be favorable or unfavorable to policyholders, etc.? (ii) Does the payment management division manage the progress of investigations in an appropriate manner to ensure prompt payment with regard to the investigations of facts concerning individual cases? (iii) Is a system in place under which adequate and accurate investigations can be conducted to confirm facts concerning insured events after obtaining the consent of the parties concerned? For example, are the following items confirmed?
Confirmation of accurate facts through inquiries with insured persons, inpatient and
outpatient hospitals, doctors in charge, etc.
In the case of insured events caused by disasters, etc., confirmation of the accuracy of
facts, etc., through inspections of accident sites, inquiries to police stations and witnesses, etc. (iv) Is a system provided which prevents investigations from improperly harming the honor, credit, privacy, etc. of related parties and third parties? (2) Prevention of inappropriate dealings with customers Does the Payment Management Division take actions to prevent inappropriate dealings with policyholders, etc., aggrieved parties in accidents, and survivors, etc.? For example, are settlements inappropriately recommended to policyholders, etc., aggrieved parties in accidents, and survivors, etc., by causing them to misunderstand terms and conditions? (3) Appraisal and determination of damages (in cases of nonlife insurance) (i) Is a system in place for the appraisal and determination of damages in an appropriate manner? For example, does the Payment Management Division manage while taking the following management points into consideration?
Are appraisals and determinations of damages conducted by assessors,
etc., in the case of fire insurance, and by experts such as adjusters in the case of automobile insurance?
Is the basis for calculating insurance claims clarified, and is the validity of such
grounds verified?
Are unpaid insurance claims managed in an appropriate manner pending the
determination of damages?
Are the payees (beneficiaries, hospitals, maintenance shops, etc.) confirmed?
(ii) Are insurance claims paid without conducting an adequate investigation of damages, in violation of the fair treatment of policyholders? (4) Settlement negotiations (in cases of nonlife insurance) Is a system provided for conducting settlement negotiations, etc. while paying attention to the following points?
Is the application of comparative negligence adequately examined?
Are consequential damages (costs for temporary use of replacement vehicles, damages
due to taking leave of absence from work, etc.) adequately examined?
Are litigation cases managed in an appropriate manner?
3) Ensuring Fast and Appropriate Payment of Insurance Claims, etc.
(1) Management of Payment Reasons
(i) For cases in which a payment reason occurs other than by a policyholder filing an insurance claim, is a system provided for management of the entire insurance contract, and to provide notice to the policyholder? Especially for reasons to pay invalidation repayments and maturity repayments, is there a system which consistently prevents missing payments due to overlooking? For example, is a system in place to prevent missing payments by IT system development? (ii) For payments related to special stipulations, is there a system which consistently prevents missing payments due to overlooking? For example, is a system in place to prevent missing payments by IT system development? (2) Mutual Checks and Balances System (i) Regarding insurance claim payment clerical work overall, is there a system provided which ensures a mutual checks and balances function, so payment/non-payment assessment is executed appropriately? For example, is there a system for verification by multiple people? (ii) For Payments of Insurance Claims, etc. which involve multiple payment divisions, from the viewpoint of preventing missing payments, is there a system for checking by coordination or mutual confirmation among payment divisions? (3) Payment Assessment (i) Is a system in place under which verifications of legality or medical judgment, etc., are sought as needed when making determinations not to pay insurance claims, etc., on the basis that payment requests do not satisfy the causes for payment or are subject to a cause for exemption? Are opinions of outside legal counsel obtained as needed and in a timely manner? (ii) Is a system in place under which facts, both favorable and unfavorable to policyholders, etc., are evaluated in a fair and appropriate manner? Specifically, is a system in place to prevent making a favorable judgment for the company while some facts remain uncertain? (4) Prevention of unfair payments Is a system in place for preventing arbitrary Payment of Insurance Claims, etc., despite the fact that there is a cause for nonpayment? For example, in response to improper demands by anti-social forces, are there resolute responses in cooperation with the Compliance Control Division and Customer Support Manager? (5) Prevention of unfair withholding of payments and delayed payments (i) Is a system in place for preventing unfair withholding of payments? For example, are unfair measures practiced such as imposing a limit on the aggregate amount of insurance claims,
etc., that are payable, or lowering the upper limits on benefit payments without reasonable grounds? (ii) Is a system in place for preventing unfair delays in payment? (iii) Is a system in place for preventing excessive persuasion that is intended to withhold the payment of insurance claims, etc.? (iv) Is a system in place under which appropriate interest charges are paid on overdue benefits after the investigation period established in stipulations has lapsed? (v) Is a system in place for preventing unfair treatment, such as refusing payment unless requests or complaints are filed repeatedly? (6) Management of Deadlines (i) Is a system provided to appropriately manage dates for calculating the start of overdue interest fees? Is there improper handling to reduce payment of overdue interest fees, for example by having the insurance claim filing reception date delayed to calculate with a date later than when actually filed? (ii) In cases where a policy is to be cancelled due to a notice duty violation or increased risk, is there a system for appropriately setting the date to start counting towards the cancellation deadline, and for providing a cancellation notice to the policyholder within the period until the cancellation deadline, based on laws and regulations, etc.? (iii) In cases of cancellation due to a serious reason, is a system in place for providing to the policyholder a cancellation notice within a reasonable time period after that serious reason was known or knowable? (7) Explanations to Policyholders (i) For cases where time is required until payment (or until notice if payment will not be made), is a system provided which takes actions such as providing easily understood explanations of the reasons for requiring that number of days, the payment target date, etc.? (ii) After an insurance claim payment is made, if an inquiry about that payment is received from the policyholder (e.g., about the grounds for calculating the payment amount), is there a system for providing a courteous and easily understood explanation, in accordance with the payment assessment criteria on which it was based? (iii) Is a system in place under which the reason for nonpayment is accurately explained, clearly showing the specific facts identified by the company and the grounds and reasons for nonpayment based on the terms and conditions of the policy? Also, is a system in place for sincere responses to questions by policyholders? For example, as needed, reconfirming facts, then providing a full and appropriate reply with the grounds and reasons for nonpayment, and moreover depending on the situation, reinvestigating the reasonableness of the assessment?
4) Storage of Records on the Process of Insurance Claims Payment Management
To enable later verification of the appropriateness of processing of insurance claims payment management, is a system in place to appropriately store records on the following?
Customer Support Management System
Processing of Consultation Requests, Complaints, etc. as Dispute-Settlement Mechanism In handling Consultation Requests, Complaints, etc., does the insurance company regard them as a nascent form of dispute-settlement issue, rather than merely as a matter to be processed, and aim as much as possible to provide solutions by obtaining the understanding and satisfaction of the Customer in a manner suited to the details of the requests and complaints?
Customer Information Management System
(1) Development of Organization for Customer Information Management With regard to information concerning customers who are individuals, is there an arrangement for the Customer Information Supervisory Manager to take the following measures as necessary and appropriate in order to prevent leakage, loss or destruction of the information as the supervisor of the information safety management as well as of employees and the Outsourcing Contractor (in the case where handling of the information concerned is outsourced)? Related to the necessity of actions based on the following provisions, keep in mind that agencies must also be included in organizations understood to be outsourcing contractors.
(3) Use of Sensitive Information
Sensitive information is stipulated in the Guidelines on Personal Information Protection in the Financial Industry, Article 6. Except for situations listed in each item in Paragraph 1 of
Article 6, is a system in place to ensure there is no acquisition, use nor provision to third
parties?
(4) Taking Customer Information Outside the Company If customer information is brought outside the company, is this limited to only required items, and are its handling methods clearly established to prevent leaks of customer information which is normally carried?
6. Outsourcing Management System
Outsourcing of Investigations
If investigation of the facts of an insurance related accident is outsourced, is a system provided for sufficient supervision of the contractor, to ensure proper investigations? For example:
15 Refer to Article 100-2-2, Paragraph 3 of the Act.
16 Refer to (7) “Securing appropriate management of other operations determined by the insurance company as necessary for protecting customers and enhancing customer convenience” listed as the first checkpoint in Chapter I of this checklist.
Checklist for Comprehensive Risk Management
I. Development and Establishment of Comprehensive Risk Management System by
Management
Checkpoints
Here, “capital, etc.” is not limited to the concept of net assets under accounting and capital based on current solvency regulations; this assumes a definition in which each insurance company compares against its risks from the viewpoint of risk management, including equity understood by economic value assessment (assessment consistent with market prices, or, assessment based on present value future cash flows indicated by a method which uses principles, techniques and parameters consistent with the market).
developed and implemented.
Does it position liability characteristics as important elements in setting strategic goals
of the entire insurance company and each division. For product development and insurance premium rate setting, does it consider the results of assessment and analysis of liability characteristics, and status of responses based on these results? Also, does it hold sufficient assets with suitable characteristics (maturities, liquidity, etc.) to enable performance on its future debts?
Does it make clear whether to aim at minimizing the risk or to aim at making a profit by
aggressively taking and managing a certain amount of risk in deciding the levels of risk-taking and profit objectives?
Does it avoid setting insurance company-wide and division-specific strategic objectives
that sacrifice risk management for short term profit? In particular, does it avoid setting objectives that pursue short-term profit by disregarding long-term risk or avoid setting a performance appraisal system that reflects such inappropriate objectives? (3) Development and Dissemination of Comprehensive Risk Management Policy Has the Board of Directors established a policy regarding comprehensive risk management (hereinafter referred to as the “Comprehensive Risk Management Policy”) and disseminated it throughout the institution? Is the appropriateness of the Comprehensive Risk Management Policy being secured by way of, for example, clear statements on the following matters?2 Regarding policy on implementation of stress tests, do its basic concepts not contradict comprehensive risk management? Does it consider the viewpoint of understanding risks which cannot be understood by techniques to quantify comprehensive risk management?
The roles and responsibilities of the director in charge and the Board of Directors or
organization equivalent to the Board of Directors with regard to comprehensive risk management
The policy on organizational framework, such as establishment of a division concerning
comprehensive risk management (hereinafter referred to as the “Comprehensive Risk Management Division”) and the authority assigned thereto
The policy regarding new products, etc.3
(including product development and insurance premium setting which sufficiently take into account risk control)
The policy for analysis and assessment of liability characteristics, such as risks created by
insurance policy options such as cancellation or renewal
The policy for holding sufficient assets with suitable characteristics (maturities, liquidity,
etc.) to enable performance on its future debts, considering its liability characteristics
The policy regarding the setting of risk limits
The policy regarding identification of risks to be managed
The policy regarding comprehensive assessment of risks and the monitoring and control
of the assessed risks
The policy regarding execution of stress tests
It is not necessary to create a comprehensive risk management policy including all items which should be clearly written. It is sufficient if the items which should be clearly written are completely established in multiple policies established by multiple divisions which conduct comprehensive risk management, and in business plans. See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4)
for adequacy of capital, etc.?
(2) Definition of Capital, etc. for Assessment of Adequacy of Capital, etc. In assessment of adequacy of capital, etc., does the Board of Directors clearly establish the definitions of capital, etc. which are assessment criteria? Considering that capital, etc. preparation for potential losses, is the definition of capital, etc. used in assessment of adequacy of capital, etc. consistent with business policy, business plans, strategic goals, etc.? (3) Establishment of Comprehensive Risk Management Division (i) Does the Board of Directors or organization equivalent to the Board of Directors have a Comprehensive Risk Management Division established and have the division prepared to undertake appropriate roles in accordance with the Comprehensive Risk Management Policy and the Comprehensive Risk Management Rules?4 (ii) Has the Board of Directors allocated to the Comprehensive Risk Management Division a Manager with the necessary knowledge and experience to supervise the division and enabled the Manager to implement management operations by assigning him/her the necessary authority therefor? (iii) Has the Board of Directors or organization equivalent to the Board of Directors allocated to the Comprehensive Risk Management Division an adequate number of staff members who have the necessary knowledge and experience to execute the relevant operations and assigned such staff the authority necessary for conducting the aforementioned operations?5 (iv) Does the Board of Directors or organization equivalent to the Board of Directors keep the Comprehensive Risk Management Division independent from the asset investment division, insurance underwriting division, etc. and secure a check-and-balance system of the Comprehensive Risk Management Division? (4) Development of Comprehensive Risk Management Systems in the Product Development Division, Asset Investment Division and Insurance Underwriting Division (i) Through the Manager or Comprehensive Risk Management Division, does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure effectiveness of comprehensive risk management, such as by providing a system to fully disseminate the relevant internal rules and operational procedures to the divisions involving
When the Comprehensive Risk Management Division is not established as an independent division (e.g., when the division is consolidated with another risk management division to form a single division or when a division in charge of other business also takes charge of comprehensive risk management or when a Manager or Managers take charge of comprehensive risk management instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division commensurate with the scales and natures of the insurance company and its risk profile. department or post, whether or not the structure of the Comprehensive Risk Management Division is reasonable in terms of a check-and-balance system and other aspects.
risks to be managed (e.g. product development division, asset investment division, underwriting division, etc.) and ensure that such divisions observe them? For example, does the Board of Directors or organization equivalent to the Board of Directors instruct the Manager to identify the internal rules and operational procedures that should be observed by the product development division, asset investment division, insurance underwriting division, etc. and to carry out specific actions for ensuring observance such as providing effective training on a regular basis? (ii) Does the Board of Directors or organization equivalent to the Board of Directors provide a system to work for appropriate coordination among the comprehensive risk management division, asset investment risk management division, insurance underwriting risk management division, liquidity risk management division, new products committee, etc.? (5) Development of System for Comprehensive Management of Assets and Liabilities Based on comprehensive risk management policy, does the Board of Directors develop a system which has the Comprehensive Risk Management Division comprehensively manage assets and liabilities, with the roles of assessing and analyzing the development and execution of investment strategy, etc.?6 (6) System for Reporting to and Approval of the Board of Directors or Organization Equivalent to Board of Directors Has the Board of Directors appropriately specified matters that require reporting and those that require approval and does it have the Manager report the current status to the Board of Directors in a regular and timely manner or on an as needed basis or have the Manager seek the approval of the Board of Directors on the relevant matters? In particular, does it ensure that the Manager reports to the Board of Directors without delay any matters that would seriously affect corporate management? (7) System for Reporting to Corporate Auditor In the case that the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately and do they provide a system to have the Manager directly report such matters to the auditor?7 (8) Development of Internal Audit Guidelines and an Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or Internal Audit Division Manager appropriately identify the matters
There are also cases in which comprehensive management of assets and liabilities is done by an organization such as an ALM Committee separate from the Comprehensive Risk Management Division. Regardless of differences of such a framework, it shall be examined whether comprehensive management of assets and liabilities is done appropriately. If an ALM committee, etc. is set up, it shall be examined whether the Comprehensive Risk Management Division and ALM committee, etc. are cooperating appropriately. It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report and shall not
to be audited with regard to comprehensive risk management, develop guidelines that specify the matters subject to internal audit and the audit procedure (hereinafter referred to as “Internal Audit Guidelines”) and an internal audit plan, and approve such guidelines and plan?8 For example, does it have the following matters clearly specified in the Internal Audit Guidelines or the internal audit plan and provide a system to have these matters appropriately audited?
reviewing their effectiveness based on reports and findings on the status of comprehensive risk management in a regular and timely manner or on an as needed basis?
3. Assessment and Improvement Activities
1) Analysis and Assessment
(1) Analysis and Assessment of Comprehensive Risk Management Does the Board of Directors or organization equivalent to the Board of Directors appropriately determine whether there are any weaknesses or problems in the comprehensive risk management system and the particulars thereof, and appropriately examine their causes by precisely analyzing the status of comprehensive risk management and assessing the effectiveness of comprehensive risk management, based on all information available regarding the status of comprehensive risk management, such as the results of audits by corporate auditors, internal audits and external audits9 , findings of various investigations and reports from various divisions? In addition, if necessary, does it take all possible measures to find the causes by, for example, establishing fact findings committees, etc. consisting of non-interested persons? (2) Revision of Analysis and Assessment Processes Does the Board of Directors or organization equivalent to the Board of Directors revise the analysis and assessment processes in a timely manner by reviewing their effectiveness based on reports and findings on the status of comprehensive risk management in a regular and timely manner or on an as needed basis?
2) Improvement Activities
(1) Implementation of Improvements
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the comprehensive risk management system identified through the analysis, assessment and examination referred to in 3. 1) above in a timely and appropriate manner based on the results obtained by developing and implementing an improvement plan as required or by other appropriate methods?
External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear it in mind that currently, audits other than the audit of financial statements required under the rules and the verification of the internal control system conducted as part of the procedures of this audit are not obligatory. However, in the case where the inspected insurance company undergoes an external audit other than the financial statements audit in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining in a comprehensive manner along with the financial statements audit results.
(2) Progress Status of Improvement Activities
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of Improvement Process Does the Board of Directors or organization equivalent to the Board of Directors revise the improvement process in a timely manner by reviewing its effectiveness based on reports and findings on the status of comprehensive risk management in a regular and timely manner or on an as needed basis?
II. Development and Establishment of Comprehensive Risk Management System By Manager
Checkpoints
10 It is not necessary to create comprehensive risk management rules including all items which should be clearly written. It is sufficient if the items which should be clearly written are completely established in multiple internal rules established by multiple divisions which conduct comprehensive risk management.
11 See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4)
weakness or problem that may affect comprehensive risk management? Moreover, from the viewpoint of appropriate comprehensive risk management which suits its risk profile, does the Manager provide a framework to identify information which should be obtained, and receive reports periodically or as needed from divisions which have that information? For example, does he receive timely and appropriate reports on the following situations?
12 See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4) 13 It should be noted that sophistication of risk management includes not only expansion of scope of risk measurement and improvement in precision and other aspects of risk management but also enhancement of measures to complement the limits and weaknesses of the management and the technique of utilizing measurement results. 14 It should be noted that the computer system may be a centralized data processing environment system, distributed processing system, or end user computing (EUC) type. The same shall apply hereafter.
suited to the scales and natures of the financial institution’s business and its risk profile? (vii) Does the Manager ensure the provision of training and education systems to enhance the ability of employees to conduct comprehensive risk management in an effective manner, thus developing human resources with relevant expertise? (viii) Does the Manager provide a system to ensure that matters specified by the Board of Directors are reported in a regular and timely manner or on an as needed basis? In particular, does the Manager provide a system to ensure that matters that would seriously affect corporate management are reported to the Board of Directors or organization equivalent to the Board of Directors without delay? (4) Revision of Comprehensive Risk Management Rules and Organizational Frameworks Does the Manager conduct monitoring on an ongoing basis with regard to the status of the execution of operations at the Comprehensive Risk Management Division? Does the Manager review the effectiveness of the comprehensive risk management system in a regular and timely manner or on an as needed basis, and, as necessary, revise the Comprehensive Risk Management Rules and the relevant organizational framework, or present the Board of Directors or organization equivalent to the Board of Directors with proposals for improvement?
2. Roles and Responsibilities of Comprehensive Risk Management Division
1) Risk Identification and Assessment
(1) Identification of Risks to Be Managed
(i) Does the Comprehensive Risk Management Division have each Risk Management Division exhaustively identify all risks faced by the bank on a category-by-category basis and identify the risks to be subjected to comprehensive risk management commensurate with the size and nature of the identified risks? Do the risks subject to comprehensive risk management exhaustively include all major risks, including at least insurance underwriting risk, market risk, credit risk and operational risk? Does the Comprehensive Risk Management Division ensure that the identification process covers the full scope of business including those of sales offices, major group companies and consignees, in addition to exhaustively covering the risk categories? (ii) Is the Comprehensive Risk Management Division also considering whether to apply comprehensive risk management to the risks not included in the calculation of the solvency margin ratio? When there are risks not covered by comprehensive risk management, has the Comprehensive Risk Management Division determined whether their effects are negligible? (iii) With regard to New Products, based on New Products management policy, does the Comprehensive Risk Management Division identify their inherent risks in advance through
each risk management division and report to the new products committee, etc. in a timely manner?15 (2) Assessment of Various Risks (i) Does the Comprehensive Risk Management Division determine the validity of the risk assessment and measurement techniques used by the Risk Management Divisions and the assumptions thereof? Or does it make sure that each risk management division examines the validity of the techniques and assumptions? Does it determine the following items, for example?:
15 See “Checklist for Business Management (Governance) (for Basic Elements),” I. 3. (4).
characteristics, risk profile and large changes in the external environment, then implement stress tests? In doing so, does it comprehensively assess and measure risks based on stress scenarios that cover incidents capable of having serious effects on the insurance company? (4) Stress Tests (i) In executing stress tests, does the Comprehensive Risk Management Division develop a system to involve people who have specialized knowledge and techniques? (ii) Does the Comprehensive Risk Management Division verify the reliability of models used in stress tests, and appropriately revise them periodically and as needed? When each risk management division verifies and revises, does the Comprehensive Risk Management Division confirm their reasonableness? (iii) Does the Comprehensive Risk Management Division sufficiently verify and analyze the results of stress tests, periodically and as needed? When each risk management division verifies and analyzes, does the Comprehensive Risk Management Division confirm their reasonableness? Also, are systems developed which use these in specific decisions on risk management?
2) Comprehensive Management of Assets and Liabilities
(1) Analysis and Assessment of Liability Characteristics Does the Comprehensive Risk Management Division appropriately analyze the situation of liability characteristics, such as risks caused by options containing liabilities, as well as assumed interest rates, duration and cash flow, taking into account the size and characteristics of the insurance company’s operations and its risk profile? (2) Comprehensive Management of Assets and Liabilities, Considering Liability Characteristics Does the Comprehensive Risk Management Division analyze and assess the situation of holding sufficient assets with suitable characteristics (maturities, liquidity, etc.) to enable performance on its future debts, considering its liability characteristics? Also, in its handling of new products, does it assess and analyze the liability characteristics of new products, and the asset investment strategies based on this? (3) Comprehensive Management of Assets and Liabilities if based on Economic Value Assessment (i) It is desirable that comprehensive management of assets and liabilities be done based on economic value, that is, value consistent with market prices, or present value of future cash flows derived by methods using principles, techniques and parameters consistent with the market. Currently, if techniques of assessment based on economic value are not completely established, for example, for assessment of risks created by insurance policy options such as
cancellation or renewal, then is it based on the best techniques that can be adopted in each company? (ii) In comprehensive management of assets and liabilities, are risks which could have important potential effects on economic value assessed in a framework of asset/liability management? Such risks include the following risks.
Market risks
Credit risks
Insurance underwriting risks
Liquidity risks
3) Implementation of Policies on Adequacy of Capital, etc.
(1) Implementation and Monitoring of Policies on Adequacy of Capital, etc. Does the Comprehensive Risk Management Division smoothly execute policies for adequacy of capital, etc., based on the business plan and capital plan, etc.? If a different division executes the policy, does the Comprehensive Risk Management Division confirm that it is executed smoothly? (2) Maintenance of Level of Capital, etc. (i) Does the Comprehensive Risk Management Division assess the adequacy of capital, etc., and sufficiently analyze and investigate to maintain a level, based on the results of monitoring the situations of its internal environment (risk profile, situation of use of risk limits, etc.) and external environment (economic cycle, markets, etc.) and reasonableness of assumptions, etc.? Also, does it confirm there is sufficient analysis and investigation to maintain a level? (ii) Does the Comprehensive Risk Management Division hypothesize a case where there is inadequate capital, etc., and analyze and investigate feasible responses such as capital reinforcement? Or does it confirm that analysis and investigation are being done? In particular, does it investigate while considering the possibility that raising capital will become more difficult than usual, due to the emergence of reputational risk, etc.?
4) Assessment of Adequacy of Capital, etc.
Assessment of Adequacy of Capital, etc.
Does the Comprehensive Risk Management Division take into account the insurance company’s unique comprehensive risk management characteristics, and assess the appropriate adequacy of capital, etc. to suit the size and characteristics of operations and its risk profile? For example, does it take into account the following items?
Does assessment of adequacy of capital, etc. indicate that the quality of capital is
suitable?
Are the methods to assess adequacy of capital, etc. and risk assessment methods
reasonable?
Does it consider the limitations and weak points of risk assessment methods?
Does it create multiple appropriate stress scenarios, analyze the degree of effects on
capital, etc. and risks, and assess the adequacy of capital, etc.? Do these stress scenarios consider major risks which greatly affect the adequacy of capital, etc.?
Is adequacy of capital, etc. assessed from a medium term viewpoint which considers
medium term business strategy and the business environment, such as changes in amounts of insurance policies held and product mix changes?
If losses appear or earnings fall, are those losses or loss occurrence risk considered when
assessing the adequacy of capital, etc.?
Risk Management Policy and the Comprehensive Risk Management Rules, provide in a regular and timely manner or on an as needed basis information necessary for the Board of Directors or organization equivalent to the Board of Directors to make an appropriate assessment and judgment with regard to the status of the comprehensive risk management, the status of the risks assessed comprehensively and the status of adequacy of capital, etc.? Does the division report the following items, for example?
organization equivalent to the Board of Directors to make decisions as to whether the financial institution should withdraw from or downsize the business affected by those risks? (2) Handling in the Case Where Risk Limits are Exceeded, etc. In the case where the financial institution has exceeded the risk limits etc., does the Comprehensive Risk Management Division provide information necessary for the Board of Directors or organization equivalent to the Board of Directors without delay to make decisions as to whether to take steps to mitigate risks or alter the limits? (3) Response if Comprehensive Management of Assets and Liabilities is Insufficient If comprehensive management of assets and liabilities is insufficient, does the Comprehensive Risk Management Division investigate feasible responses for holding sufficient assets with suitable characteristics (maturities, liquidity, etc.) to enable performance on its future debts? Or if a different division creates the response plan, does the Comprehensive Risk Management Division quickly investigate and report information to the Board of Directors or organization equivalent to the Board of Directors, enabling it to take decisions? (4) Response if Capital, etc. is Inadequate If capital, etc. is inadequate, does the Comprehensive Risk Management Division quickly investigate feasible responses such as capital reinforcement? Of if a different division creates the response plan, does the Comprehensive Risk Management Division quickly investigate, and report information to the Board of Directors or organization equivalent to the Board of Directors, enabling it to take decisions on specific responses?
7) Review and Revision
(1) Sophistication of Risk Management
Does the Comprehensive Risk Management Division conduct a review to grasp the limitations and weaknesses of the Comprehensive Risk Assessment Method and devise countermeasures to complement the method? Does it conduct investigations, analysis and consideration commensurate with those limitations and weaknesses with a view to making risk management more sophisticated commensurate with the risk profile? (2) Review and Revision of Comprehensive Risk Management Method Does the Comprehensive Risk Management Division grasp the limitations and weaknesses of the Comprehensive Risk Assessment Method and the method of assessing adequacy of capital etc. as well as changes in the internal and external environments, and regularly review whether the methods suit the insurance company-wide strategic objectives, the scales and natures of the business in question and the risk profile of the insurance company in its entirety, and revise the method? Does the division review and revise the following items, for example:
Validity of the identification of risks to be subjected to comprehensive risk management
Validity of the Comprehensive Risk Assessment Method
Appropriateness of the operation of the comprehensive risk assessment method
commensurate with its limitations and weaknesses
In assessment of adequacy of capital, consistency between the definition of capital, etc.,
etc., and the business policy, business plan, strategic goals, etc. Reasonableness of grounds for deciding on definition.
Reasonableness of identification of risks subject to management in assessment of
adequacy of capital, etc.
Reasonableness of methods (assessment and measurement techniques, assumptions, etc.)
of assessing risks in assessment of adequacy of capital, etc.
Reasonableness of methods of assessing adequacy of capital, etc.
Appropriateness of operations, considering the limitations and weak points of methods
of assessing adequacy of capital, etc.
(3) Verification and Revision of Methods of Comprehensive Management of Assets and Liabilities Does the Comprehensive Risk Management Division analyze liability characteristics? In order to hold sufficient assets with suitable characteristics (maturities, liquidity, etc.) corresponding the situation of the liabilities it holds, does the Comprehensive Risk Management Division periodically revise after verifying whether it has appropriate methods of comprehensive management of assets and liabilities which are suitable for the changes in its external environment, the situation of its business strength such as capital, the strategic goals of the entire insurance company, the size and characteristics of its operations, and the risk profile?
Checkpoints
etc.) in order to allocate to payments when there are reasons to pay insurance benefits, etc.
16 If an ALM committee is not set up, examine whether its functions are in an alternative risk management process.
(2) Appropriate Involvement of Directors and Corporate Auditors (i) Understanding of Integrated Risk Measurement Technique (a) Do directors understand that decisions concerning the integrated risk measurement technique as well as the risk limits and the Risk Capital limits (in the case where capital allocation management is employed) have serious implications for the financial institution’s corporate management and financial conditions? (b) Does the director in charge of integrated risk management understand the integrated risk management technique required for the business of the insurance company and have a grasp on the nature (limitations and weaknesses) thereof? (c) Do directors and corporate auditors seek to enhance their understanding of the integrated risk management technique by participating in training courses or through other means? (ii) Approach to Integrated Risk Management17 When needed, do directors involve themselves actively in integrated risk management based on the integrated risk measurement technique? (3) Integrated Risks Measurement (i) Appropriateness of Measurement Technique (a) With regard to the various risk measurement techniques used by the Comprehensive Risk Management Division, is the validity of each of them ensured, and is consistency among those techniques secured with a view to measuring risks appropriately in an integrated manner? (b) Are the assumptions that underlie the risk measurement conducted by the Comprehensive Risk Management Division reasonable in light of the strategic objectives and the risk profile? (c) Is the technique used by the Comprehensive Risk Management Division to aggregate various risks with different risk nature and loss distributions appropriate? When correlations among various risks (distribution effect) are taken into consideration, does the division regularly validate the correlations? (ii) Ongoing Validation and Stress Test (a) Does the Comprehensive Risk Management Division regularly analyze the appropriateness of the measuring techniques through ongoing validation (back testing, etc.)? Are revisions of the measuring techniques conducted in accordance with the internal rules? (b) Does the Comprehensive Risk Management Division consider the limitations and weak points of integrated risk measurement techniques, grasp the stress status of various risks
17 In this examination item, “Comprehensive Risk Management” refers to measuring various risks by using VaR or other comprehensive methods among comprehensive risk management methods, integrating the various risks (totaling), and comparing them against the insurance company’s capital.
individually and the risks as a whole through stress tests based on a comprehensive and appropriate stress scenarios, and make appropriate use of the test results? (iii) Systems for Validating and Managing the Integrated Risk Measurement Technique Were the integrated risk measurement technique and the assumptions thereof validated during the development of the technique and thereafter on a regular basis by a person or persons with no involvement in the development and with sufficient capabilities? If any deficiency is recognized in the integrated risk measurement technique or the assumptions thereof, is a corrective action taken appropriately? Are there frameworks and internal rules to prevent the integrated risk measurement technique and the assumptions thereof from being altered on unreasonable grounds, and is the integrated risk measurement technique managed appropriately in accordance with the internal rules? (4) Records on Integrated Risk Measurement Technique Are systems developed for the purpose of keeping records for future reference on the review process with regard to the selection of the integrated risk measurement technique and the assumptions thereof and the grounds for the selection process in order to enable follow-up verification and utilize the records to make the measurement more sophisticated and elaborated? (5) Audits (i) Development of Auditing Program Is an auditing program that exhaustively covers the auditing of the integrated risk measurement technique in place? (ii) Scope of Internal Audits Is auditing conducted to check the following items?
Consistency of the integrated risk measurement technique with the strategic objectives,
the scales and natures of business and the risk profile
Appropriateness of the business in light of the nature (limitations and weaknesses) of the
integrated risk measurement technique
Records on the integrated risk measurement technique are appropriately documented and
updated in a timely manner
Appropriate incorporation of alterations to the process of integrated risk management
into the risk measurement technique
Appropriateness of the scope of the risks measured by the integrated measurement
technique
Absence of any deficiency in the information system for the management
Validity of the integrated risk measurement technique and the assumptions thereof
Validity of the method of aggregating various risks
Accuracy and completeness of the data used in integrated risk measurement
Adequacy of the process and results of ongoing verification (backtesting, etc.)
(iii) Utilization of Auditing Results
Does the Comprehensive Risk Management Division appropriately revise the integrated risk measurement technique based on the results of auditing? (6) Utilization of Management Indicators with Due Consideration for Risks Does the Comprehensive Risk Management Division utilize management indicators such as return on equity not only for the purpose of grasping performance but also for that of enhancing risk management?18 When management indicators are utilized, are they used to review the reasonableness of the risk-return strategy, etc.?
18 It should be noted that the level of utilization of return on equity and other management indicators varies according to the corporate management policy, strategic objectives, etc.
(Attachment)
I. Situation of Top Management’s Development and Establishment of a Management System
for Financial Soundness and Actuary
Checkpoints
19 It is not necessary to create a comprehensive Policy on Management of Financial Soundness and Actuary including all items which should be clearly written. It is sufficient if the items which should be clearly written are completely established in multiple policies established by multiple divisions which conduct management of financial soundness and actuary.
referred to as the “Manager” in this Attachment) develop internal rules that clearly specify the arrangements concerning management of financial soundness and actuary (hereinafter referred to as the “Rules on Management of Financial Soundness and Actuary”) and make them known to related staff, in accordance with the Policy on Management of Financial Soundness and Actuary? Has the Board of Directors or organization equivalent to the Board of Directors approved the Rules on Management of Financial Soundness and Actuary, after determining whether they comply with the Policy on Management of Financial Soundness and Actuary and after legal checks, etc.? (2) Establishment of Division Managing Financial Soundness and Actuary Division Managing Financial Soundness and Actuary, and have the division prepared to undertake appropriate roles in accordance with the Policy on Management of Financial Soundness and Actuary, and Rules on Management of Financial Soundness and Actuary?20 (ii) Has the Board of Directors allocated to the Division Managing Financial Soundness and Actuary a Manager with the necessary knowledge and experience to supervise the division, and enabled the Manager to implement management operations by assigning him/her the necessary authority therefor? (iii) Has the Board of Directors or organization equivalent to the Board of Directors allocated to the Division Managing Financial Soundness and Actuary an adequate number of staff members who have the necessary knowledge and experience to execute the relevant operations, and assigned such staff the authority necessary for conducting the aforementioned operations?21 (3) Development of System for Reporting to and Approval of the Board of Directors or Organization Equivalent to Board of Directors Has the Board of Directors appropriately specified matters that require reporting and those that require approval and does it have the Manager report the current status to the Board of Directors or organization equivalent to the Board of Directors in a regular and timely manner
20 If the Division Managing Financial Soundness is not established as an independent division (e.g., if functions concerning management of financial soundness and actuary are divided among multiple different management divisions, or if a division in charge of other business (Comprehensive Risk Management Division, etc.) also takes charge of management of financial soundness and actuary, or if a Manager takes charge of management of financial soundness and actuary instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division. 21 When a department or a post other than the Board of Directors or organization equivalent to the Board of Directors department or post, whether or not the structure of the Division Managing Financial Soundness and Actuary is reasonable in terms of a check-and-balance system and other aspects.
or on an as needed basis or have the Manager seek the approval of the Board of Directors or organization equivalent to the Board of Directors on the relevant matters? In particular, does it ensure that the Manager reports to the Board of Directors without delay any matters that would seriously affect corporate management? (4) Development of System for Reporting to Corporate Auditor In the case that the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately, and does it provide a system to have the Manager directly report such matters to the auditor?22 (5) Development of Internal Audit Guidelines and an Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or Internal Audit Division Manager appropriately identify the matters to be audited with regard to management of financial soundness and actuary, develop guidelines that specify the internal audit subjects and the audit procedure (hereinafter referred to as “Internal Audit Guidelines”) and an internal audit plan, and approve such guidelines and plan?23 For example, does it have the following matters clearly specified in the Internal Audit Guidelines or the internal audit plan and provide a system to have these matters appropriately audited?
22 It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report and shall not 23 The Board of Directors or organization equivalent to the Board of Directors only needs to have approved the basic
financial soundness and actuary in a regular and timely manner or on an as needed basis?
II. Manager’s Development and Establishment of System for Management of Financial
Soundness and Actuary
Checkpoints
24 It is not necessary to create comprehensive Rules on Management of Financial Soundness and Actuary including all items which should be clearly written. It is sufficient if the items which should be clearly written are completely established in multiple internal rules established by multiple divisions which conduct management of financial soundness and actuary.
25 It should be noted that the computer system may be a centralized data processing environment system, distributed processing system, or end user computing (EUC) type.
Checkpoints
(ii) In cases when the written opinion, etc., contains a statement that policy reserves are not provided for in an appropriate manner, does the Board of Directors take corrective measures in accordance with such an opinion? If it does not follow the opinion, is there reasonable cause, for example, that such an opinion is not in conformity with the Practical Guidelines? (iii) When chief actuaries point out in a written report that part or all of the deficiency in policy reserves, etc. (as defined in the Practical Guidelines; hereinafter the same) need not be provided for due to a change in management policy, and the Board of Directors of the life insurance company decides not to make additional provisions on the basis of such an opinion, does the Board of Directors actually take measures to effect such a change of management policy?
2) Calculation of Amount of Policy Reserves etc.
(i) Does the Division Managing Financial Soundness and Actuary calculate the amounts to be provided for Policy Reserves, etc. appropriately in conformity with provision policies, laws and regulations, etc.? In doing so, does it perform verification by referring to changes in outstanding balances and by means of sampling? (ii) Does the Division Managing Financial Soundness and Actuary manage the schedule appropriately, based on written procedures, etc.? (iii) Does the Division Managing Financial Soundness and Actuary provide to the chief actuaries the timely and appropriate information required for the chief actuaries to perform work, such as information needed to create scenarios used in Item 1 Cash Flow Analysis?
3) Policy Reserves, etc., of Life Insurance Companies
(1) Policy reserves
(i) Are policy reserves classified into premium reserves, unearned premiums, refundable provision, and contingency reserves, as set forth in Article 69 of the Enforcement Regulations, calculated and provided for in accordance with the actuarial statement of insurance premiums and policy reserves (hereinafter referred to as “Actuarial Statement”), after appropriately recognizing the insurance policies in force at the end of accounting periods? (ii) Regarding premium reserves and unearned premiums, are the following items considered? a. Is it appropriately determined based on when insurance policies were concluded and the type of insurance policies, in conformity with laws and regulations, etc., whether insurance policies are subject to standard policy reserves? b. When policy reserves are provided for under the Zillmer method, are the Zillmer percentage and the Zillmer period appropriate, and do their levels exceed surrender values?
c. When policy reserves are provided for under the Zillmer method, are additional
provisions made systematically for the purpose of providing for policy reserves under the net level premium method? d. Are calculation items for policy reserves aggregated in an appropriate manner? Are the causes verified for items that were significantly changed from the year earlier? (iii) Regarding contingency reserves, are the following items considered? a. Are contingency reserves managed after classifying them into contingency reserve for underwriting risk (Contingency Reserve I), contingency reserve for insurance underwriting risk of third sector insurance (Contingency Reserve IV), contingency reserve for assumed interest rate risk (Contingency Reserve II), and contingency reserve for minimum guarantee risk (Contingency Reserve III) as set forth in Article 69, Paragraph 6 of the Enforcement Regulations? b. Are the provisions for Contingency Reserve I, Contingency Reserve IV, Contingency Reserve II, and Contingency Reserve III in excess of the standard amounts, respectively, calculated pursuant to “Notice Specifying the Criteria concerning Provision and Reversal to be Specified by the Commissioner of the FSA, Pursuant to Provisions of the Insurance Business Act Enforcement Regulations, Article 69, Paragraph 7 (Ministry of Finance Notice No. 231 of 1998)” (referred to hereinafter as “Notice No. 231”), Article 2, Article 3, and Article 3-2? Conversely, are such amounts in excess of the ceilings of provisions set forth in the Notice?
c. When contingency reserves are reversed, is such reversal in conformity with the
reversal standards set forth in Article 6 of Notice No. 231? d. Are contingency reserves provided for risks other than normal death risk, accidental death risk, pure endowment risk, hospitalization due to accident risk, or hospitalization due to illness risk (for example, three major diseases, etc.), which are set forth in Notice No. 231, based on the Notice and in accordance with the method set forth in the Actuarial Statement in an appropriate manner? (iv) Regarding policy reserves for insurance policies with which the amount of insurance claims, etc., fluctuates in accordance with the value of assets in separate accounts, are the following items considered? a. Is the balance of revenues and expenditures of separate accounts provided for as policy reserves for separate accounts? b. In the case of insurance policies for which a minimum amount of insurance claims is guaranteed, is the amount set forth in “Notice Specifying the Method of Provision of Policy Reserves and the Basic Calculation Ratio (Paragraph 5, Item 1 of Ministry of
Finance Notice No. 48 of 1996)” provided for as the policy reserves of general accounts?
c. Is Contingency Reserve III provided for variable annuity insurance policies that were
concluded on or before March 31, 2005 and with which a minimum amount of insurance claims, etc., is guaranteed as well? (2) Reserves for outstanding claims (i) Regarding standard reserves for outstanding claims, are the following items considered? a. Is the reserve for insurance claims, etc., for which the occurrence of a reason for payment has been reported and the duty of payment has arisen but the disbursement for payment of such claim has not been made as yet (the “standard reserve for outstanding claims”) provided for in an appropriate manner pursuant to Article 73, Paragraph 1, Item 1 of the Enforcement Regulations? In providing for such reserves, is the information received from policyholders, etc., concerning insured events appropriately managed and are the projected payment amounts reasonably estimated? b. Are the standards for calculations of the amount to be provided for as the standard reserve for outstanding claims set appropriately in view of the insurance claim payment standards? In addition, when such calculation standards are changed, are the reason and requirements for such changes valid?
c. Does the calculation division have the status of the occurrence of the reasons for
payment as understood by the company accurately reflected in the period-end estimation process, pending the determination of the amount of insurance claims to be paid? d. With respect to the reserves for outstanding claims concerning inward reinsurance underwritten for overseas insurers (the “estimated reserves for outstanding claims for inward reinsurance for overseas insurers”), in cases when reports concerning insured events cannot be obtained from ceding parties, etc., due to differences in the accounting system of the countries of the ceding parties, etc., or other factors, but if such reserve can be calculated by a reasonable method taking into account recent historical experience, is such calculated amount provided for as the standard reserve for outstanding claims? (ii) Regarding IBNR reserve, are the following items considered? a. Is the reserve for insurance claims, etc., for which the obligation for payment is deemed to have arisen although claim reports of the occurrence and the reason for payment have not been received (reserves for outstanding claims for insured events that have been “incurred but not reported”; the “IBNR reserve”) provided for in conformity with “Notice Specifying the Amount to be Provided as Reserves for Outstanding Claims, Pursuant to Provisions of Insurance Business Act Enforcement Regulations, Article 73,
Paragraph 1, Item 2 (Ministry of Finance Notice No. 234 of 1998)” (hereinafter referred to as “Notice No. 234”) Article 1, in accordance with the classification of insurance pursuant to Article 73, Paragraph 1, Item 2 of the Enforcement Regulations? b. In cases when Article 73, Paragraph 2 is applied instead of Notice No. 234, is the amount calculated in accordance with the method set forth in the Actuarial Statement provided for as the IBNR reserve? (3) Dividend reserves In the case of insurance companies, is the reserve for dividends to policyholders provided for in the liability section in accordance with Article 30-5, Paragraph 2 of the Enforcement Regulations? Furthermore, is the equalized reserve for dividends to policyholders provided for in the net asset section as a voluntary surplus reserve? In addition, in the case of joint-stock companies, is the reserve for dividends to policyholders provided for pursuant to Article 64 of the Enforcement Regulations?
4) Policy Reserves, etc., of Nonlife Insurance Companies
(1) Policy reserves
(i) Are policy reserves classified into the reserve for standard policies, abnormal contingency reserve, refund provisions, and reserve for dividends to policyholders, etc., as set forth in
Article 70 of the Enforcement Regulations, after appropriately recognizing insurance policies
in force at the end of accounting periods, and calculated and provided for in accordance with the Actuarial Statement and the “Notice Specifying the Amount Used in Calculation of Policy Reserves of Non-life Insurance Companies, Pursuant to Provisions of Insurance Business Act Enforcement Regulations, Article 70, Paragraph 4 (Ministry of Finance Notice No. 232 of 1998)” (hereinafter referred to as “Notice No. 232”)? (ii) Regarding standard policy reserves, is the larger of the sum of the premium reserves and unearned premiums calculated in accordance with Notice No. 232 and the net proceeds in the initial fiscal year (premiums received in such fiscal year, less the insurance claims, surrender values, and reserves for outstanding claims paid in the same fiscal year for the policies for which premiums were received and the operating expenses incurred during the same fiscal year) provided for as standard policy reserves? (iii) Regarding standard policy reserves, are premium reserve or refund reserve appropriately provided for in accordance with Article 70, Paragraph 2, Item 1 of the Enforcement Regulations for insurance policies commencing on or after April 1, 2001 that are the type of insurance policies as set forth in Article 3, Paragraph 5, Item 2 of the Law (third-sector insurance) excluding those with a coverage period of one year or less (in the case of
insurance policies with which saving accounts are established, insurance policies with the coverage period of ten years or shorter)? (iv) Regarding abnormal contingency reserves, are the following items considered? a. Is the larger of the minimum provision amount set forth in the Actuarial Statement and the maximum provision amount approved under tax laws provided as an abnormal contingency reserve pursuant to Article 2, Item 2 of Notice No. 232? In addition, are filings made as needed pursuant to this Notice? b. When a provision is made in excess of such an upper limit, is the reason for such provision valid?
c. If the abnormal contingency reserve is reversed, is such reversal in conformity with
Article 2, Item 1 of Notice No. 232?
d. When the level and method of provisions are changed, is the reason for that change valid and acceptable? (v) Regarding refund provisions, are the following items considered? a. Is the refund provision appropriately provided for based on the Actuarial Statement in conformity with Article 70, Paragraph 2, Item 1 of the Enforcement Regulations? b. With respect to the refund reserve for insurance policies in separate accounts, is the balance of the net proceeds in those separate accounts provided for as refund reserve in conformity with Article 70, Paragraph 2, Item 3 of the Enforcement Regulations? (vi) Regarding reserve for dividends to policyholders, are the following items considered? a. Are the reserve for dividends to policyholders (restricted) and the reserve for dividends to policyholders (unrestricted) provided for in accordance with the Actuarial Statement? In addition, is the reserve for dividends to policyholders (unrestricted) provided for within the maximum amount and in excess of the required amount? b. When the standards for provision and reversal of the reserve for dividends to policyholders (unrestricted) are changed, are the reasons for such changes valid? (vii) Regarding policy reserves concerning automobile liability insurance and earthquake insurance, are the amounts calculated in accordance with the Actuarial Statement provided for in an appropriate manner for the reserves (obligatory reserve, adjustment reserve, investment profit reserve, and additional percent reserve) set forth in the “Order on Provision of Reserves under Article 28-3, Paragraph 1 of the Automobile Liability Security Act (Ordinance No. 1 of 1997 of the Ministry of Finance; the Ministry of Health and Welfare; the Ministry of Agriculture, Forestry and Fisheries; and the Ministry of Transport),” and are the policy reserves as set forth in Article 7 of the Enforcement Regulations of the Law Concerning Earthquake Insurance?
(2) Reserves for outstanding claims
(i) Regarding standard reserves for outstanding claims, are the following items considered? a. Is the standard reserve for outstanding claims appropriately provided for in accordance with Article 73, Paragraph 1, Item 1 of the Enforcement Regulations? When making provisions, is information from policyholders, etc., concerning insured events managed in an appropriate manner, and are the expected payment amounts reasonably estimated in making provisions? b. Are the standards for calculation of the amounts to be provided as the standard reserve for outstanding claims set appropriately in view of the insurance claim payment standards? In addition, when such calculation standards are changed, are the reason and requirements for such changes valid?
c. Does the calculation division comprehend the status of the occurrence rate of the reasons
for payment by the company, and the rates accurately reflected in the period-end estimation process pending the determination of the amount of insurance claims to be paid? d. With respect to the estimated reserve for outstanding claims for inward reinsurance for overseas insurers, in cases when reports concerning insured events cannot be obtained from ceding parties, etc., due to differences in the accounting system of the countries of the ceding parties, etc., or other factors, but if such reserve can be calculated by a reasonable method taking into account recent historical experience, is such calculated amount provided for as the standard reserve for outstanding claims? (ii) Regarding IBNR reserves, are the following items considered? a. Is the IBNR reserve provided for in conformity with Article 2 of Ministry of Finance Notice No. 234 in accordance with the classification of insurance pursuant to Article 73, Paragraph 1, Item 2 of the Enforcement Regulations? b. In cases when Article 73, Paragraph 2 is applied instead of Notice No. 234, is the amount as calculated in accordance with the method set forth in the Actuarial Statement provided for the IBNR reserve?
5) Roles of Chief Actuaries
(i) Do the chief actuaries appropriately check whether policy reserves, etc. are provided for based on sound actuarial science, in accordance with laws, regulations, etc.? (ii) Are the chief actuaries appropriately involved in calculation of reserves for outstanding claims, in accordance with laws, regulations, etc.? (iii) To check whether policy reserves are provided for based on sound actuarial science, do the chief actuaries of the life insurance company do Item 1 Cash Flow Analysis in accordance
with laws, regulations, etc.? In particular, are they based on past results and reasonable future forecasts for increase in numbers of new policies, asset investment conditions, etc.? Moreover, in principle, is cash flow analysis done for each product segment in segmented accounting, with an analysis period at least 10 years into the future? (iv) Are the chief actuaries involved in methods of calculating insurance premiums and policy reserves and in other insurance actuary related matters? And for their IT system changes, do the chief actuaries coordinate with related divisions, and accurately report problems to the Board of Directors or organization equivalent to the Board of Directors? (v) Do the chief actuaries submit written opinions to the Board of Directors? Do the written opinions contain the items established in laws, regulations, etc.?
6) Reinsurance
(i) When Policy Reserves, etc. are not provided for because reinsurance has been purchased, does the coordinating division confirm whether the reinsurer satisfies the requirements set forth in the items of Article 71, paragraph 1 of the Enforcement Regulations, and cooperate with the reinsurance risk management division to confirm whether there is high probability of recovery of reinsurance claims? Does the division comprehend at least the financial condition, etc. of the reinsurer? (ii) Does the coordinating division confirm whether the fees received in advance that are related to financial reinsurance that has been purchased as set forth in Article 1 of “Notice Specifying Reinsurance Specified by the Commissioner of the FSA, pursuant to Provisions of the Insurance Business Act Enforcement Regulations, Article 71, Paragraph 2 (Ministry of Finance Notice No. 233 of 1998)” (fees calculated based on the revenue expected to arise from the portion of the reinsured insurance policy) are provided for as policy reserves in an appropriate manner? In addition, when reinsurance other than financial reinsurance is purchased and the fees calculated based on the revenue expected to arise from the portion of the reinsured insurance are received, does the coordinating division confirm whether such fees are recorded as deposits received in an appropriate manner? (iii) With respect to the reinsurance with which reinsurance premiums and the amount of reinsured claims are adjusted after the reinsurance contract, does the coordinating division confirm whether the amount equivalent to additional reinsurance premiums or the amount of reinsured claims to be returned is appropriately provided for as policy reserves or other liabilities in the accounting period during which such reinsurance is purchased (excluding those cases in which post-contract adjustment is an insignificant element)?
(iv) When providing for Policy Reserves, etc. for reinsured policies, is it confirmed whether the amount deductible from the reserve is not in excess of the risk portion substantially transferred by reinsurance? (v) When the company underwrites reinsurance for other insurance companies, does the coordinating division confirm whether policy reserves or the reserves for outstanding claims are appropriately provided for, by comprehending the risk related to such reinsurance, in view of the fact that it is not necessarily appropriate to treat reinsurance underwriting risk in a similar manner with ordinary underwriting risk, due to the complexity of contracts and actual conditions when reinsurance is underwritten for other insurance companies?
7) Measures for Treatment of a Deficiency of Policy Reserves
In cases when a deficiency of policy reserves is expected to occur or it is deemed that there is likelihood that the future performance of obligations will be hindered (Article 69, Item 5; or,
Article 70, Item 3 of the Enforcement Regulations) as a result of confirmation work conducted
by chief actuaries using Item 1 Cash Flow Analysis, are appropriate measures taken as set forth below, etc.? (i) In cases when a deficiency of policy reserves is expected to occur within the next five years as a result of Item 1 Cash Flow Analysis, while it is permissible that part or all of such policy reserves need not to be provided for if business management policies are changed in accordance with the written opinion of chief actuaries, is the basis (plans, etc.) for holding that such changes can immediately be implemented specifically documented? (ii) In cases when a deficiency of policy reserves is expected to occur within the next five years as a result of Item 1 Cash Flow Analysis, and such deficiency of policy reserves cannot be overcome even with a change of business management policies, and it is necessary to provide for additional policy reserves pursuant to the provisions of Article 69, Item 5 of the Enforcement Regulations, do insurance companies immediately provide for additional policy reserves or otherwise take necessary measures by formulating reasonable plans for providing policy reserves and by changing the Actuarial Statement? Are the additional provisions in response to deficiencies of policy reserves in this case made in principle by the type of products being accounted for separately? (iii) In cases when it is deemed a likelihood exists that the future performance of obligations will be hindered at a nonlife insurance company, does the company immediately provide for additional policy reserves or otherwise take necessary measures by formulating reasonable plans for providing policy reserves and by amending the Actuarial Statement?
8) External Audit of Policy Reserves, etc.
Is provision of Policy Reserves, etc. appropriately audited by an accounting auditor? Also, for the life insurance company’s Item 1 Cash Flow Analysis, do the chief actuaries submit a copy of written opinions and a copy of supporting attachments to the accounting auditor? Moreover, do the chief actuaries cooperate with the corporate auditors and accounting auditor, and work to share information needed to perform each of their duties?
2. Appropriateness of Calculation of the Solvency Margin Ratio
(1) Calculation of Solvency Margin Ratio
To gain the trust of policy holders, etc., does Board of Directors calculate the proper solvency margin ratio in accordance with the calculation in “Notice Specifying Criteria for whether there is a Proper Status of Sufficient Ability to Pay Insurance Benefits, etc., based on Provisions of the Insurance Business Act, Article 130, Article 202 and Article 228 (1999 FSA and Ministry of Finance Notice No. 3)?” (2) Roles of Chief Actuaries Do the chief actuaries appropriately check whether there is a proper status of sufficient ability to pay insurance benefits, etc. based on actuarial science, in accordance with laws, regulations, etc.? (3) Amounts of Capital, Funds, Reserves, etc. (i) Are the amounts of capital, funds, reserves, etc. calculated in accordance with the specifications of Notice No. 50, Article 1 and Article 1-2? (ii) Is the amount corresponding to the tax effect (amount of deferred tax assets) included in the net assets section calculated appropriately in view of the intent of accounting standards and Practical Guidelines regarding tax effect accounting, such as “Audit Guideline for Considering Recoverability of Deferred Tax Assets” (November 9, 1999, Japanese Institute of Certified Public Accountants, Audit Committee Report)? Is the amount corresponding to the tax effect reported appropriately in view of the intent of Notice No. 50? (iii) Is the allowance for employees’ retirement benefits appropriately reported in liabilities (in assets if prepaid pension cost) accordance with the “Accounting Standard for Retirement Benefits” (June 16, 1998, Business Accounting Council) and “Practical Guideline for Accounting of Retirement Benefits” (September 14, 1999, Japanese Institute of Certified Public Accountants, Accounting System Committee Report No. 13)? (iv) If real estate has been sold, and then repurchased at a price at or near the prior selling price after its market value has fallen, and as a result, large unrealized losses are incurred, is the repurchase price used as the assessed value? (v) If the insurance company has borrowed through subordinated loans or issued subordinated
bonds, does such borrowing, etc., meet the qualifications for strengthening the company’s ability to make payments of insurance claims, etc., under Notice No. 50, Article 1, Paragraph 3, Item 6, and Paragraphs 4 through 7? (vi) Did an insurance company that has raised capital provide bypass loans, etc. to the lenders, etc. of subordinated loans, etc., for funding such loans, etc.? (vii) With regard to the holdings of shares or other capital-raising instruments of other insurance companies or subsidiaries, etc., which are required to be deducted as “deduction items” from the total solvency margin as stipulated in Article 1-2 of Notice No. 50, is it confirmed whether such holdings are deemed as “intentional holdings” in view of the intention of the Supervisory Guidelines? If such holdings are subject to the rules for “intentional holdings,” the amount of such holdings is required to be deducted from the total solvency margin of lender insurance companies. Is such deduction appropriately performed? (4) Appropriateness of the Amount Equivalent to Risk Exceeding Normal Estimates (i) Is the amount equivalent to risk exceeding normal estimates calculated in accordance with the provisions of Notice No. 50? (ii) When calculating the amount equivalent to minimum guarantee risk, are the following items considered? a. Is it calculated in accordance with the standard method or an alternative method? In addition, in the case of variable insurance policies, etc. concluded on or before March 31, 2005 for which a minimum amount of insurance claims, etc. is guaranteed, has the amount equivalent to minimum guarantee risk been calculated? b. When hedging is used to mitigate minimum guarantee risk, is such hedging treated in accordance with the provision of Exhibit 6-2, II.3 of Notice No. 50?
c. When reinsurance is purchased, is such risk deducted within the amount of risk
transferred by issuing outward reinsurance?
(iii) In calculation of amount equivalent to credit risk, are the following items considered? a. Is the credit risk for calculation of solvency margin ratios reduced by intentionally excluding from risk management loans any loans that must be reported as risk management loans? b. If the insurance company holds loans with guarantees extending into the next fiscal year or existing at the end of the fiscal year, is the credit risk for calculation of solvency margin ratios reduced, notwithstanding the fact that such guarantees, etc., expire within one year? Provided, however, that when such guarantees, etc. are reasonable, and if it can be expected that they will continue to reduce credit risk, the foregoing shall not apply.
(iv) In calculating amount equivalent to derivative transactions risk, with respect to derivative transactions with a negative risk factor (e.g., long put options on foreign currencies or stocks), it must be confirmed whether the following transactions are subject to the rules for “cases when intentional transactions are conducted” as set forth in Article 2, Paragraph 8, Items 1 and 2 of Notice No. 50, and if so, whether such transactions are deducted appropriately:
at a future point in time as estimated based on reasonable projections” exceeds the “amount of liabilities at a future point in time as estimated based on reasonable projections” at the end of the first five fiscal years covered by such analysis? Also, do the chief actuaries of the non-life insurance company check that “total of amount of substantial net assets on reference date, plus amount of cash flow in the fiscal year after the reference fiscal year” is not below the “amount equivalent to risk,” in accordance with Practical Guidelines? (iii) When Item 3 Optional Scenarios defined in the Practical Guidelines are used, are such scenarios reasonable and objective? For example:
a. Are the changes in the elements of an Item 3 Optional Scenarios over time in the future reasonable, in view of the current status of the business operations of the insurance company? b. Are the relationships coherent between the elements (e.g., the amount of new policies and operating expenses, fluctuations in bond prices and interest rates, maturity of insurance policies in force and the occurrence rate of insured events, etc.) of Item 3 Optional Scenarios?
c. Is it demonstrated in supporting attachments that each Item 3 Optional Scenario is
justifiable? d. Are Item 3 Optional Scenarios later compared with the actual results that ensued, and if any differences are found, are their causes investigated? (iv) In life insurance companies, are the scenarios used in Item 3 Cash Flow Analysis in conformity with the Practical Guidelines? Also, in non-life insurance companies, is cash flow in the fiscal year after the reference fiscal year calculated in accordance with the Practical Guidelines? (v) In cases when it was determined by Item 3 Cash Flow Analysis that a deficit as defined in the criteria for continuation of the life insurance business is expected to arise during the next five years, but it is stated in the written opinion of chief actuaries that such deficit can be eliminated if business management policies are changed, is the basis (plans, etc.) for implementing such change demonstrated, and is there a high feasibility of such change? Is it demonstrated in the written opinions for the following fiscal year and thereafter that such business management policies were implemented? If not, are the causes and remedial measures to be taken in the future demonstrated? (vi) In cases when it was determined by Item 3 Cash Flow Analysis that a deficit as defined in the criteria for continuation of the non-life insurance business is expected to arise, but it is stated in the written opinion of chief actuaries that such deficit can be eliminated if business management policies are changed, is the basis (plans, etc.) for implementing such change
demonstrated, and is there a high feasibility of such change?
Is it demonstrated in the written opinions for the following fiscal year and thereafter that such business management policies were implemented? If not, are the causes and remedial measures to be taken in the future demonstrated? (vii) If the results of Item 3 Cash Flow Analysis differ significantly from the results of analyses conducted in the past, are the causes explained in attached reports?
2) Profit source analysis
(i) Is the method adopted by insurance companies for profit source analysis appropriate in relation to the business characteristics of the company (business scale, growth rate, sales channels, etc.) and the product mix?26 (ii) Does the Board of Directors or organization equivalent to the Board of Directors receive reports concerning the results of profit source analysis and utilize such reports as an aid for decision making concerning overall business management, including annual policyholder dividends, product development, cost reductions, and sales planning, etc.?27 (iii) When understanding the actual business operations by profit source analysis, the following points need to be considered. a. Mortality (or contingency) gains and losses, which represent the basic component of the profit of insurance companies, normally exhibit stable trends. Accordingly, if any of the following situations are observed regarding mortality (or contingency) gains and losses, it shall be verified whether, for example, revenues and expenditures have been transferred from other profit sources to post false mortality (or contingency) gains and losses:28
26 Insurance premiums are calculated based upon a number of assumptions (actuarial assumption rates), and most of the insurance company’s profits are derived from the difference between these assumptions and actual operational results. Accordingly, in order to comprehend the true state of business and to project both current and future profits, it is important to separate profits for analysis purposes into components corresponding to actuarial assumption rates and into other components (such as the three major sources of profit, and policy reserve related profit and loss, etc.). Among the methods used for such profit source analysis is the standard analysis method (account balance method) with which insurance companies are required to report to regulatory authorities. However, given the current business environment and product lines which include products with low surrender benefits, variable annuities (with a minimum guarantee), and third-sector products, the appropriateness of this method shall be determined on a case-by-case basis, depending on respective circumstances. In the case of nonlife insurance companies also, the appropriateness of such a method shall be determined on a case-by-case basis from the same perspective. 27 Profit source analysis is a business analysis method widely used among life insurance companies. Even for nonlife insurance companies, with the introduction of third-sector products with longer policy terms, the usefulness of profit source analysis has increased. 28 As the standard profit source analysis method (account balance method) employs policy reserves as a calculation element, if the calculation of policy reserves exhibits abnormal values, such abnormal values also appear in the results of mortality (contingency) gains and losses. This mechanism is also utilized for the purpose of confirming the valuation calculations of policy reserves.
29 In view of the occurrence of negative spread issues, etc., it shall be noted that pursuit of investment performance solely based on yield does not necessarily lead to improvement in true investment management efficiency.
system for matters concerning segmented accounting with large effects on the business to be quickly reported to the Comprehensive Risk Management Division or Internal Audit Division, and reported to the Board of Directors or organization equivalent to the Board of Directors? (3) Points to Keep in Mind regarding Segmented Accounting (i) Determination of product classifications a. Are product classifications, which are used for the purpose of managing profit, loss, and liabilities, performed in an appropriate manner as units for measuring profit and loss in view of the nature of products and the status of policies in force? For example, are the following managed, in principle, using separate accounts:
non-refundable, short-term insurance and savings-type, long-term insurance; non-participating insurance and participating insurance; fixed assumed interest rate insurance and variable assumed interest rate insurance; personal insurance and business insurance; and so on? In principle, are the riders, etc., that are attached to basic policies, classified into the same product category as the related basic policies? b. If increases in particular types of new policies in force due to the release of such new products, or an increase in particular types of insurance belonging to certain product classifications, etc., materially influences either the revenues and expenditures of the entire insurance company or certain product classifications, and if new product classifications or sub-classifications of the same type of insurance are to be established as a result, are such classifications or sub-classifications performed under a reasonable method, taking into account fairness among policyholders, etc.?
c. Do pre-existing product classifications remain unchanged (including the integration into
other product classifications) without a reasonable basis (in cases when policies in force have decreased or such product classifications have ceased to have meaning, etc.)? (ii) Establishment of a companywide classification a. Is a companywide classification for managing the profits, losses, and liabilities that cannot be allocated to a single product classification established to ensure the smooth management of product classifications? b. Are companywide classifications managed in a way that exceeds the limits of their functions? Specific functions of a companywide classification, in principle, include the following:
risk buffering functions to cope with death protection risk, price fluctuation risk,
business management risk, etc.;
operational funding functions related to new products and product development;
management functions related to the assets collectively owned by the entire insurance
company and shared expenses of the entire company; and
management functions related to cash and deposits, etc.
(iii) Establishment of asset classifications a. When establishing asset classifications for the purpose of allocating returns on asset management in a fair and equitable manner, are the nature of insurance policies and the effects on revenues and expenditures of the entire insurance company taken into consideration, and the nature, etc., of respective product classifications taken into account? b. When existing asset classifications are to be further divided due to expansion of their size, etc., are such sub-classifications established under a reasonable method, taking into account fairness among policyholders, etc.?
c. If the assets in a certain asset classification decrease and the asset classification ceases
to have meaning as a result, is such asset classification eliminated and the assets integrated into some other asset classification? In this case, are the residual assets that do not belong to a specific type of policy integrated into the common asset classification? (iv) Method of allocating assets and liabilities into product classifications a. Allocation into product classifications Are policy reserves (excluding contingency reserve), reinsurance liabilities, and other liabilities that are directly linked to insurance products, directly included in their respective product classifications in full, and are income taxes payable, allowance for retirement benefits, and other liabilities that cannot be classified directly, allocated in accordance with the Allocation Standards? b. Allocations to the companywide classification Is the net assets section (excluding earned surplus brought forward, valuation and currency translation adjustments, etc.), and the reserve for price fluctuations, contingency reserve, and any other liabilities which do not belong to a single product classification allocated to the companywide classification?
c. Management of sources of liabilities and net assets belonging to the companywide
classification
With respect to the net assets section items belonging to the companywide classification such as reserve for equalized dividends to policyholders, or any other liabilities for the purpose of performing risk buffer functions, are their sources managed so as to identify which product classifications comprise those classifications?
(v) Method of allocating assets into asset classifications and management standards a. Method of allocating investment assets When assets are acquired for investment purposes in accordance with the nature of certain products, are such assets allocated, in principle, to the asset classifications corresponding to the product classifications to which such products belong? b. Management of investment assets Are investment assets managed under the most suitable method selected from among the following methods for each asset classification, taking into account the characteristics of respective product classifications and asset sizes, etc.?
30 When the equity interest management method is adopted, entire product lines and general account assets (excluding assets that correspond to non-participating insurance) may not be treated as a single major class.
(4) Allocation of profits and losses a. Insurance-related profits and losses Are insurance premium revenues, etc., insurance claim payments, etc., provisions for outstanding claims, and provisions for policy reserves, etc., allocated directly to respective product classifications? b. Investment asset-related profits and losses Are profits and losses allocated to the asset classifications to which the investment assets belong, and then further allocated directly, or in proportion to respective equity interests to product classifications or the companywide classification? When multiple product classifications are managed under one and the same asset classification, are the profits and losses allocated in accordance with the Allocation Standards?
c. Method for allocating profit and loss, other than the foregoing, that cannot be directly
charged to product classifications
Are operating expenses that cannot be allocated directly to product classifications or the companywide classification, such as salaries of officers and employees, and taxes, allocated in accordance with the Allocation Standards? (5) Transactions between asset classifications Are transactions between asset classifications limited to transactions conducted for the purpose of clarifying the accounting of transactions between different asset classifications, such as for the purpose of managing funds transfers (inflows and outflows), ensuring liquidity, or portfolio improvements? Are such transactions conducted at market prices or other fairly determined prices? (6) Transactions between product classifications and the companywide classification Are loans, investments, or other transactions that are conducted for compelling reasons between product classifications and the companywide classification, for the purpose of ensuring liquidity of funds or smooth payment of insurance claims, etc., treated in accordance with the following approaches? a. Loans of cash and deposits, etc. (a) Is each loan separated from other product classifications, and managed? (b) Are ceilings set on loans, etc., for respective product classifications to prevent net borrowing positions from continuing? b. Loans of items other than cash and deposits, etc. (a) In the case of loans from the companywide classification to product classifications, are such loans limited to unavoidable cases when insurance claim payments are concentrated in particular product classifications, losses due to abnormal contingencies
have arisen, or a shortage of operating capital for promoting sales of new products has arisen, and so forth? (b) In the case of loans from product classifications to the companywide classification, are such loans limited to such cases when the size of the companywide classification is too small to perform its functions adequately? (c) In the case of loans set forth in (a) and (b) above, are the amounts, interest rates (which shall be determined based on market interest rates, etc., in accordance with the loan duration), repayment dates, and other repayment terms and conditions predetermined? (d) Are the easing of loan conditions and the discharge of debt obligations limited to unavoidable situations when an unrecoverable loss has occurred, and so forth? Provided however, when debt obligations have been discharged, it shall be verified whether requisite measures were taken, such as the cessation of new sales of the products or revisions of insurance claims related to applicable product classifications. In cases when profit has arisen after loan conditions were eased in such a way as not to affect the loan principle by exemption or reduction of interest or the grant of a grace period for principle repayment, is such profit appropriated to compensate for the easing of loan conditions?
c. Investment
(a) Is the investment from the companywide classification in product classifications limited to such unavoidable cases when insurance claim payments are concentrated in particular product classifications, losses due to abnormal contingencies have arisen, or a shortage of operating capital for promoting sales of new products has arisen, and so forth? (b) Are investments from product classifications in the companywide classification limited to such cases as when the size of the companywide classification is too small to perform its functions adequately? (c) In cases when a surplus has arisen in the companywide classification or in product classifications that have received an investment, is the surplus amount that equates to such investment distributed to the companywide classification or product classification that provided the investment? (d) Is an investment reclassified after its purpose has been completed? d. Other transactions Notwithstanding the foregoing provisions of a. through c., transactions between product classifications and the companywide classification concerning the provision and reversal of contingency reserve, etc., payment by product classifications of fees and commissions for jointly-owned assets (operating real estate, etc.) belonging to the companywide classification, or joint expenses paid by the companywide classification
(general administrative staff wages, etc.), and the transactions described below that are equivalent to the above, shall consequently be conducted on an extremely limited scale from the viewpoint of ensuring fair and transparent distributions of profit to policyholders, eliminating internal support among differing types of insurance, and the appropriate management of separate accounting. Accordingly, is a system in place under which such transactions are appropriately conducted in full recognition of such intents? (a) When capital or contingency reserve, etc., are to be increased, are transactions for respective product classifications to share the requisite amounts conducted in an appropriate manner? (b) When the capital or contingency reserve, etc., that belong to the companywide classification are to be reversed, are transactions conducted in an appropriate manner for the companywide classification to pay the applicable reversed amounts to the respective product classifications? In this case, if reserve for equalized dividends to shareholders and other voluntary reserves or liabilities that are managed under the equity interest method are reversed for an amount in excess of the equity interest held by such product classifications, are such excess portions appropriately processed and deemed as if loans were provided from the companywide classification to such product classifications? (c) When insurance plans are changed due to conversion, etc., and as a result the product classifications to which such policies belong are changed, are transactions conducted in an appropriate manner for recording the sum total of principal and interest of policy reserves and accumulated dividends related to such policies from the product classifications to which such policies belonged prior to the foregoing change to the product classifications to which such policies belong after the change? (d) When the companywide classification advances expenses related to new policies, are the transactions conducted in an appropriate manner for recording the payment of the amount equivalent to new policy expenses out of the premiums received from the respective product classifications to the companywide classification? (e) Are the transactions by which the companywide classification receives fees, commissions, or other amounts in consideration of managing jointly held assets or common expenses conducted in an appropriate manner and in accordance with the asset management and operations procedures? (f) When losses are actually incurred in respective product classifications upon the occurrence of certain specified risks, are the transactions for compensation of an amount within the limit of such incurred losses, from the companywide classification to the product classification where such risks and losses have arisen, limited to cases when
respective product classifications have transferred in advance the amount determined under certain actuarial standards as consideration? (g) In addition to the cases listed in items (a) through (f) above, when respective product classifications receive funds from another product classification within an extent that will not influence the insurance claims payment ability, etc., of such other product classifications as in the cases described below, are such funds appropriately managed in accordance with the intents of such measures? These cases are:
Are mortality (or contingency) gains or losses, interest gains or losses, expense profits or losses, policy reserve-related profits or losses, price fluctuation gains or losses, and other profits or losses, etc., analyzed and examined from the viewpoints of managing separate accounting in an appropriate manner and ensuring sound business operations? (11) Utilization of Results Obtained from Separate Accounting (i) Are chief actuaries provided with the information concerning separate accounting that is necessary for the execution of actuarial operations, and if any issues are identified, do chief actuaries report such issues to the Board of Directors or organization equivalent to the Board of Directors and endeavor at the same time to provide guidance in addressing such issues? (ii) Does the Board of Directors or organization equivalent to the Board of Directors receive reports concerning the results of separate accounting and utilize such reports in decision making for policyholder dividends and other managerial issues?
4) Policyholder Dividends
(i) Does the Board of Directors or organization equivalent to the Board of Directors determine dividend payments in accordance with laws and regulations, contract clauses, internal rules, and written opinions of chief actuaries, and by taking into account fairness and equality among policyholders? (ii) Are the sources of funds for dividend payments accurately calculated, and are there any problems with such sources of funds in relation to restrictions by laws or regulations? Are the sources of funds necessary for dividend payments subject to accounting manipulation? (iii) Is the amount of dividends payable for each insurance policy calculated pursuant to the methods defined in the items of Article 30-2 and Article 62 of the Enforcement Regulations? (iv) Do chief actuaries conduct confirmations concerning policyholder dividends in an appropriate manner, in conformity with laws and regulations, etc.?
Checklist for Insurance Underwriting Risk Management
I. Development and Establishment of Insurance Underwriting Risk Management System by
the Management
Checkpoints
provisions and intentions of the Insurance Business Act, other related laws and regulations, and supervisory guidelines.
Here, “capital, etc.” is not limited to the concept of net assets under accounting and capital based on current solvency regulations; this assumes a definition in which each insurance company compares against its risks from the viewpoint of risk management, including equity understood by economic value assessment (assessment consistent with market prices, or, assessment based on present value future cash flows indicated by a method which uses principles, techniques and parameters consistent with the market).
(hereinafter referred to as the “Insurance Underwriting Risk Management Policy”)? Has it informed the entire company? Are they appropriate? For example, are the following matters clearly written?
Excluding cases with insignificant ratios of reinsurance assumed and ceded compared to held risks.
the “Insurance Underwriting Risk Management Rules”) and inform the organization in accordance with the Insurance Underwriting Risk Management Policy? Has the Board of Directors or organization equivalent to the Board of Directors approved the Insurance Underwriting Risk Management Rules, after determining if they comply with the Insurance Underwriting Risk Management Policy and after legal checks, etc.? (2) Establishment of Insurance Underwriting Risk Management Division (i) Does the Board of Directors or organization equivalent to the Board of Directors have an Insurance Underwriting Risk Management Division established, and have the division prepared to undertake appropriate roles, in accordance with the Insurance Underwriting Risk Management Policy and the Insurance Underwriting Risk Management Rules?3 (ii) Has the Board of Directors allocated to the Insurance Underwriting Risk Management Division a Manager with the necessary knowledge and experience to supervise the division, and enabled the Manager to implement management operations by assigning him/her the necessary authority therefor? (iii) Does the Board of Directors provide a framework for having important information of divisions related to New Products etc. reported to the Insurance Underwriting Risk Management Division? Also, is the definition of important information clearly stipulated in rules? (iv) Has the Board of Directors or organization equivalent to the Board of Directors allocated to the Insurance Underwriting Risk Management Division an adequate number of staff members who have the necessary knowledge and experience to execute the relevant operations, and assigned such staff the authority necessary for conducting the aforementioned operations?4 (v) Does the Board of Directors or organization equivalent to the Board of Directors keep the Insurance Underwriting Risk Management Division independent from the asset investment division, Marketing and Sales Division, etc., and secure a check-and-balance system of the Insurance Underwriting Risk Management Division? (3) Development of Insurance Underwriting Risk Management System in Marketing and Sales Division
When the Insurance Underwriting Risk Management Division is not established as an independent division (e.g., when the division is consolidated with another risk management division to form a single division, or when a division in charge of other business also takes charge of insurance underwriting risk management, or when a Manager or Managers take charge of insurance underwriting risk management instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division commensurate with the size and nature of the insurance company and its risk profile. department or post, whether or not the structure of that deportment or post is reasonable in terms of a check-andbalance system and other aspects.
(i) Through the Manager or Insurance Underwriting Risk Management Division, does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure effectiveness of insurance underwriting risk management, such as by providing a system to inform the divisions involving insurance underwriting risks to be managed (e.g. Marketing and Sales Division, etc.) about the internal rules and operational procedures which must be observed, and to ensure that such divisions observe them? For example, does the Board of Directors or organization equivalent to the Board of Directors instruct the Manager to identify the internal rules and operational procedures that must be observed by the Marketing and Sales Division, etc., and to carry out specific actions for ensuring observance such as providing effective training on a regular basis? (ii) To enable the Insurance Underwriting Risk Management Division to understand required information about assets, does the Board of Directors or organization equivalent to the Board of Directors provide a system for appropriate cooperation with the asset investment risk management division? Does it also provide a system for appropriate cooperation with the Comprehensive Risk Management Division? (4) Development of System for Reporting to and Approval of the Board of Directors or Organization Equivalent to the Board of Directors Does the Board of Directors or organization equivalent to the Board of Directors appropriately specified matters that require reporting and those that require approval, and does it have the Manager report the status to the Board of Directors in a regular and timely manner or on an as needed basis, or have the Manager seek the approval of the Board of Directors? In particular, does it ensure that the Manager reports to the Board of Directors or organization equivalent to the Board of Directors without delay any matters that would seriously affect corporate management? (5) Development of System for Reporting to Corporate Auditor In the case that the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately, and do they provide a system to have the Manager directly report such matters to the auditor?5 (6) Development of Internal Audit Guidelines and an Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or Internal Audit Division Manager appropriately identify the matters to be audited with regard to insurance underwriting risk management, develop guidelines that specify the matters subject to internal audit and the audit procedure (hereinafter referred to as “Internal Audit Guidelines”) and an internal audit plan, and approve such guidelines and
It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report, and shall not
plan?6
For example, does it have the following matters clearly specified in the Internal Audit Guidelines or the internal audit plan, and provide a system to have these matters appropriately audited?
External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear it in mind that currently, audits other than the audit of financial statements required under the rules and the verification of the internal control system conducted as part of the procedures of this audit are not obligatory.
and reports from various divisions? In addition, if necessary, does it take all possible measures to find the causes by, for example, establishing fact findings committees, etc. consisting of non-interested persons? (2) Revision of Analysis and Assessment Processes Does the Board of Directors or organization equivalent to the Board of Directors revise the analysis and assessment processes in a timely manner, by reviewing their effectiveness based on reports and findings on the status of insurance underwriting risk management in a regular and timely manner or on an as needed basis?
2) Improvement Activities
(1) Implementation of Improvements
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the insurance underwriting risk management system, identified through the analysis, assessment and examination referred to in 3. 1) above, in a timely and appropriate manner based on the results obtained, by developing and implementing an improvement plan as required or by other appropriate methods? (2) Progress Status of Improvement Activities Does the Board of Directors or organization equivalent to the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner, by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of Improvement Process Does the Board of Directors or organization equivalent to the Board of Directors revise the improvement process in a timely manner, by reviewing its effectiveness based on reports and findings on the status of insurance underwriting risk management, in a regular and timely manner or on an as needed basis? However, in the case where the inspected insurance company undergoes an external audit other than the financial statements audit in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining in a comprehensive manner along with the financial statements audit results.
II. Development and Establishment of Insurance Underwriting Risk Management System By
Manager
Checkpoints
Roles, responsibilities, and organizational framework of the Insurance Underwriting
Risk Management Division
Identification, assessment, monitoring and control of insurance underwriting risks
Comprehensive management of assets and liabilities
Analysis and assessment of liability characteristics. For example, risks created by
insurance policy options such as cancellation or renewal.
Insurance underwriting standards (sales conditions)
Approval and screening of New Products, etc. (including arrangements on analysis and
assessment of liability characteristics of New Products, etc.)
Cooperation with the Comprehensive Risk Management Division
Reinsurance related risk management8 (including (1) holding limit amounts for each
risk unit and each concentrated risk unit, corresponding to characteristics of underwriting risks held, (2) standards on soundness of reinsurers and management of concentration in one reinsurer, (3) standards on types and regions for assuming reinsurance)
Management of the special account (including arrangements on explanation to
policyholders about investment policy and investment content, arrangements on reporting to policyholders about investment results, principles which must be followed in the market, and standards on selection of companies for placing orders, discretionary managers and advisors, comprehensively considering their transaction execution ability, legal compliance, credit risk, investment performance, etc.)
System for reporting to Board of Directors or organization equivalent to Board of
Directors
(3) Development of Insurance Underwriting Risk Management System by Manager (i) Based on the Insurance Underwriting Risk Management Policy and Insurance Underwriting Risk Management Rules, does the Manager provide for actions to have the Insurance Underwriting Risk Management Division exercise a check-and-balance system, in order to conduct insurance underwriting risk management appropriately? (ii) Does the Manager provide a system which quickly reports to the Comprehensive Risk Management Division, if system weak points or problems are found which affect comprehensive risk management? (iii) Does the Manager provide a system in which if a request is received from the Comprehensive Risk Management Division about New Products, etc., then the inherent insurance underwriting risks are identified in advance, and reported to the Comprehensive Risk Management Division, based on New Products Management Policy? 9 (iv) Does the Manager provide a highly reliable insurance underwriting risk management system10 which suits the size and characteristics of operations and risk profile of the
Excluding cases with insignificant ratios of reinsurance assumed and ceded compared to held risks. See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4). 10 It should be noted that the computer system may be a centralized data processing environment system, distributed
business?
(v) Does the Manager ensure the provision of training and education systems to enhance the ability of employees to conduct insurance underwriting risk management in an effective manner, thus developing human resources with relevant expertise? (vi) Does the Manager provide a system to ensure that matters specified by the Board of Directors or organization equivalent to the Board of Directors are reported in a regular and timely manner or on an as needed basis? In particular, does the Manager provide a system to ensure that matters that would seriously affect corporate management are quickly reported to the Board of Directors or organization equivalent to the Board of Directors? Does the Manager also provide a system for actuarial science related matters being reported to chief actuaries? (4) Development of Insurance Underwriting Screening System by Manager (i) Does the Manager provide an appropriate screening system for underwriting, from the viewpoint of insurance underwriting risk management? (ii) Does the Manager provide a system for management of and self-inspecting the reasonableness of the insurance premium structure of risk segmentation products (products with segmented insurance premiums affected by risks of the policyholders or insured parties)? (iii) Does the Manager provide a system for eliminating moral risks? For example, by stricter underwriting decisions if there are excessive insured amounts relative to underwriting standards (including insured amounts concerning other insurance contracts the company learned of)? (iv) Does the Manager provide a system for appropriately selecting physical risks concerning the insured person’s health situation and occupation related environmental risks, and taking appropriate actions to eliminate moral risks? (5) Revision of Insurance Underwriting Risk Management Rules and Organizational Frameworks Does the Manager conduct monitoring on an ongoing basis, with regard to the status of the execution of operations at the Insurance Underwriting Risk Management Division? Does the Manager review the effectiveness of the insurance underwriting risk management system in a regular and timely manner or on an as needed basis, and, as necessary, revise the Insurance Underwriting Risk Management Rules and the relevant organizational framework, or present proposals for improvement to the Board of Directors or organization equivalent to the Board of Directors? processing system, or end user computing (EUC) type.
investigations done without improper influence by the Marketing and Sales Division?11
2) Monitoring
(i) Does the Insurance Underwriting Risk Management Division monitor the risk situation of
11 See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4). 12 Excluding cases with insignificant ratios of reinsurance assumed and ceded compared to held risks. 13 “Written opinions, etc.” means written opinions, attachments to reports, and other reference materials pursuant to
Article 82 of the Enforcement Regulations.
risks identified and assessed with appropriate frequency, considering the situation of the insurance company’s internal environment (risk profile and situation of use of risk limits set, etc.) and external environment (economic cycle, market, etc.), based on Insurance Underwriting Risk Management Policy and the Insurance Underwriting Risk Management Rules? Does it also monitor the status of the internal environment and external environment, as well as reasonableness of assumptions, etc.? (ii) Does the Insurance Underwriting Risk Management Division report information on the situation of insurance underwriting risk management periodically or as needed, which enables appropriate assessment and decisions by the Board of Directors or organization equivalent to the Board of Directors, based on Insurance Underwriting Risk Management Policy and the Insurance Underwriting Risk Management Rules?
3) Control
(i) Does the Insurance Underwriting Risk Management Division analyze known risks, and when risks are seen emerging or when changes are seen in future risks, is there appropriate risk control in cooperation with related divisions, such as changes in underwriting standards and added provision of Policy Reserves, in accordance with Insurance Underwriting Risk Management Policy? (ii) Does the Insurance Underwriting Risk Management Division guide and manage business locations and insurance solicitors, so they follow underwriting standards in insurance sales? Does it also take actions to check these are actually followed? For managing sales conditions, it is desirable to build an IT system which prevents signing insurance contracts which violate underwriting standards.
4) Examination and Revision
(i) Does the Insurance Underwriting Risk Management Division examine to understand the limits and weak points of insurance underwriting risk assessment methods, and take actions to supplement these methods? Also, considering these limits and weak points, does the division investigate, analyze and study for advanced risk management commensurate with the risk profile? (i) Does the Insurance Underwriting Risk Management Division understand changes in the internal and external environments, and the limitations and weak points of insurance underwriting risk assessment methods? Does the division periodically examine and revise whether it uses appropriate insurance underwriting risk management methods which suit the entire insurance company’s strategic goals, Comprehensive Risk Management Policy, business size and characteristics, and risk profile?
Checkpoints
for example are the following points kept in mind?
(i) For appropriate risk management, is follow-up incorporated in the product development process? (ii) Regarding follow-up after sales, are its viewpoints, departments in charge, time period, techniques, and methods of utilizing results determined and implemented? (iii) Is there verification of reasonableness of the basic calculation ratio for revenue/expenditure analysis, insurance premiums and Policy Reserves, for each appropriate unit such as by insurance type? (iv) Is there periodic monitoring against unexpected revenue/expenditure changes and increases/decreases in risks? Are standards established for timely investigation in response to changes in sales policy and product details? (v) Do product details suit the guarantee needs of the society and economy? Is there periodic monitoring on whether they cause complaints and moral risks? (vi) Are results of follow-up after product sales start reported directly when needed to the Board of Directors or organization equivalent to the Board of Directors? Is the content of such reports correct? (vii) Is a framework provided which has future product development incorporate results of follow-up, such as collecting opinions from customers and agencies regarding products? (viii) Are insurance premiums and product details revised as needed, based on follow-up results? (3) Freely Set Premiums in Non-life Insurance Companies (i) For freely set premium rates, standard premium rates, legal range premium rates, and limited range premium rates, are actions taken to check that individual premium rates are set in accordance with Insurance Underwriting Risk Management Policy? (ii) If there are discounts on insurance premiums of standard premium rate products, is there appropriate involvement?
2. Reinsurance Related Risk Management14
(1) Risk Management of Ceding Reinsurance
(i) In selecting a company for ceding reinsurance, is it confirmed that the reinsurer’s financial details are studied in accordance with holding & reinsurance ceding policy? Also, is the reinsured amount of each insurance product checked periodically, in accordance with holding & reinsurance ceding policy? (ii) Is it checked that underwriting risk which exceeds the holding limit amounts under holding & reinsurance ceding policy is appropriately covered by reinsurance arranged?
14 Excluding cases with insignificant ratios of reinsurance assumed and ceded compared to held risks.
(iii) Is there checking of the collection status of reinsurance benefits, its future collection possibilities, and ceded reinsurance results? (iv) For reinsurance premiums or reinsurance benefit amounts which are adjusted afterwards, is risk managed with accurate understanding of the actual status of resulting risk transfer? (v) Considering the actual status and market trends of ceded reinsurance contracts, is it checked that ceded reinsurance premiums are at reasonable levels? (2) Risk Management of Assumed Reinsurance (i) In signing assumed reinsurance contracts, is information obtained on the ceding insurer and on assumed insurance contracts, and is there full investigation of the profitability and risks of those reinsurance contracts? (ii) Is the forecast maximum insurance loss amount in major concentrated risks understood, and appropriately managed so the insurance limit amount is not exceeded? (In the case of a nonlife insurance company) (iii) Is there appropriate management even after signing an assumed reinsurance contract? For example, is information obtained on the situation of occurrence of payment responsibility of the ceding reinsurer, caused by insured accidents in other countries? (iv) For risks which should have been transferred to another party via ceded reinsurance, is there full consideration of cases in which these risks flow back via assumed reinsurance? Is this managed? (v) Considering the actual status and market trends of assumed reinsurance contracts, is it checked that assumed reinsurance premiums are at reasonable levels?
3. Management of Special Accounts
(i) In investing the special account, is property pertaining to the special account invested faithfully and very carefully for the interests of policyholders, accurately understanding its aspect that all investment results including losses pertain to policyholders, and treating them fairly and equitably? (ii) Is property pertaining to the special account correctly separated in accounting? Also, are there no transfers into the general account or other special accounts, except if stipulated in laws and regulations? (iii) Are investment policy and investment details appropriately explained to policyholders? (iv) Are investment results periodically reported to policyholders? (v) Is a special account for investment results linked insurance contracts (special designated account) managed based on provisions of the Enforcement Regulations, Article 75-2 and
Article 154-2?
Checklist for Asset Investment Risk Management
I. Development and Establishment of Asset Investment Risk Management System by
Management
Checkpoints
functioning effectively, and whether the roles and responsibilities of the company’s management are being appropriately performed by way of reviewing, with the use of check items listed in Chapter I., whether or not the management is appropriately implementing (1) policy development, (2) development of internal rules and organizational frameworks and (3) development of a system for assessment and improvement activities.
and Comprehensive Risk Management Policy? Does it inform the organization about these goals? In creating the investment division’s strategic goals, does it maintain consistency with the strategic goals of each operating area, and consider the situation of composition of assets and liabilities (including off balance sheet), market and liquidity aspects, equity, etc.?1 Also, does it consider, for example, the following items?
1 Here, “capital, etc.” is not limited to the concept of net assets under accounting and capital based on current solvency regulations; this assumes a definition in which each insurance company compares against its risks from the viewpoint of risk management, including equity understood by economic value assessment (assessment consistent with market prices, or, assessment based on present value future cash flows indicated by a method which uses principles, techniques and parameters consistent with the market).
2 See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4).
undertake appropriate roles, in accordance with the Asset Investment Risk Management Policy and the Asset Investment Risk Management Rules?3 (ii) Has the Board of Directors allocated to the Asset Investment Risk Management Division a Manager with the necessary knowledge and experience to supervise the division, and enabled the Manager to implement management operations by assigning him/her the necessary authority therefor? (iii) Has the Board of Directors or organization equivalent to the Board of Directors allocated to the Asset Investment Risk Management Division an adequate number of staff members who have the necessary knowledge and experience to execute the relevant operations, and assigned such staff the authority necessary for conducting the aforementioned operations?4 (iv) Does the Board of Directors or organization equivalent to the Board of Directors keep the Asset Investment Risk Management Division independent from the asset investment division, etc., and secure a check-and-balance system of the Asset Investment Risk Management Division? (4) Development of Asset Investment Risk Management System in Asset Investment Division (i) Through the Manager or Asset Investment Risk Management Division, does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure effectiveness of asset investment risk management, such as by providing a system to inform the divisions involving asset investment risks to be managed (e.g. asset investment division, etc.) about the internal rules and operational procedures which must be observed, and to ensure that such divisions observe them? For example, does the Board of Directors or organization equivalent to the Board of Directors instruct the Manager to identify the internal rules and operational procedures that must be observed by the asset investment division, etc., and to carry out specific actions for ensuring observance such as by providing effective training on a regular basis? (ii) To enable the Asset Investment Risk Management Division to understand required information about assets, does the Board of Directors or organization equivalent to the Board of Directors provide a system for appropriate cooperation with the Insurance Underwriting Risk Management Division? Does it also provide a system for appropriate cooperation with the Comprehensive Risk Management Division?
When the Asset Investment Risk Management Division is not established as an independent division (e.g., when the division is consolidated with another risk management division to form a single division, or when a division in charge of other business also takes charge of asset investment risk management, or when a Manager or Managers take charge of asset investment risk management instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division commensurate with the size and nature of the insurance company and its risk profile. department or post, whether or not the structure of that deportment or post is reasonable in terms of a check-and-balance system and other aspects.
(5) Development of System for Reporting to and Approval by the Board of Directors or organization equivalent to the Board of Directors Does the Board of Directors or organization equivalent to the Board of Directors appropriately specify matters that require reporting and those that require approval, and does it have the Manager report the status to the Board of Directors in a regular and timely manner or on an as needed basis, or have the Manager seek the approval of the Board of Directors? In particular, does it ensure that the Manager reports to the Board of Directors or organization equivalent to the Board of Directors without delay any matters that would seriously affect corporate management? (6) Development of System for Reporting to Corporate Auditor In the case that the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately, and does it provide a system to have the Manager directly report such matters?5 (7) Development of Internal Audit Guidelines and Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or Internal Audit Division Manager appropriately identify the matters to be audited with regard to asset management risk management, develop guidelines that specify the matters subject to internal audit and the audit procedure (hereinafter referred to as “Internal Audit Guidelines”) and an internal audit plan, and approve such guidelines and plan?6 For example, does it have the following matters clearly specified in the Internal Audit Guidelines or the internal audit plan, and provide a system to have these matters appropriately audited?
It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report, and shall not
2) Improvement Activities
External audits as mentioned here shall not be limited to audits of financial statements by accounting auditors, but the inspector should bear it in mind that currently, audits other than the audit of financial statements required under the rules and the verification of the internal control system conducted as part of the procedures of this audit are not obligatory. However, in the case where the inspected insurance company undergoes an external audit other than the financial statements audit in order to secure the effectiveness of the internal control system, the inspector should review the effectiveness of the internal control system by examining in a comprehensive manner along with the financial statements audit results.
(1) Implementation of Improvements
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the system, identified through the analysis, assessment and examination referred to in 3. 1) above, in a timely and appropriate manner based on the results obtained, by developing and implementing an improvement plan as required or by other appropriate methods? (2) Progress Status of Improvement Activities Does the Board of Directors or organization equivalent to the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner, by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of Improvement Process Does the Board of Directors or organization equivalent to the Board of Directors revise the improvement process in a timely manner, by reviewing its effectiveness based on reports and findings on the status of asset investment risk management, in a regular and timely manner or on an as needed basis?
II. Development and Establishment of Asset Investment Risk Management System by
Manager
Checkpoints
asset investment risk limits corresponding to the liability characteristics of each group)
Management Division, based on New Products Management Policy?8 For example, are there reports about effects on asset investment by liability characteristics of New Products etc.? (iv) Does the Manager understand the limitations and weak points of Asset Investment Risk Assessment Methods, and provide a system for advanced risk management which suits the size, characteristics of operations and its risk profile?9 (v) Does the Manager provide a highly reliable asset investment risk management IT system10 which suits the size and characteristics of operations, and its risk profile? (vi) Does the Manager ensure the provision of training and education systems to enhance the ability of employees to conduct asset investment risk management in an effective manner, thus developing human resources with relevant expertise? (vii) Does the Manager provide a system to ensure that matters specified by the Board of Directors or organization equivalent to the Board of Directors are reported in a regular and timely manner or on an as needed basis? In particular, does the Manager provide a system to ensure that matters that would seriously affect corporate management are quickly reported to the Board of Directors or organization equivalent to the Board of Directors? (4) Revision of Asset Management Risk Management Rules and Organizational Framework Does the Manager conduct monitoring on an ongoing basis, with regard to the status of the execution of operations at the Asset Investment Risk Management Division? Also, does the Manager review the effectiveness of the asset investment risk management system in a regular and timely manner or on an as needed basis, and, as necessary, revise the Asset Investment Risk Management Rules and the relevant organizational framework, or present proposals for improvement to the Board of Directors or organization equivalent to the Board of Directors?
2. Roles and Responsibilities of Asset Investment Risk Management Division
1) Asset Investment Risk Identification and Assessment
(i) Does the Asset Investment Risk Management Division identify and assess market risks, credit risks, real estate investment risks and liquidity risks for all assets, in a numerical or specifically verifiable manner, including for important group companies (within a scope which does not conflict with laws, regulations, etc.)? Are these also assessed for assets for which risk amount and current value cannot be objectively measured? If asset investment is outsourced, does the division identify and assess risks concerning asset investment by the outsourcing contractor? In identifying and assessing each risk, the following points must be
See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4). It should be noted that sophistication of risk management includes not only expansion of scope of risk measurement and improvement in precision and other aspects of risk management, but also enhancement of actions to complement the limitations and weaknesses of the management, and the techniques of utilizing measurement results. 10 It should be noted that the computer system may be a centralized data processing environment system, distributed processing system, or end user computing (EUC) type. Same hereinafter.
kept in mind. a. Market Risks
11 See “Checklist for Business Management (Governance) (for Basic Elements),” Chapter I. 3. (4).
(v) Does the Asset Investment Risk Management Division investigate the validity of each risk assessment and measurement technique, assumptions, etc.? Also, does it check that each risk management division is investigating their validity? For example, are the following matters investigated?
2) Monitoring
(1) Monitoring of Asset Investment Risks
Does the Asset Investment Risk Management Division monitor the status of that insurance company’s asset investment risks with appropriate frequency, considering the situation of the insurance company’s internal environment (characteristics of liabilities held, risk profile, situation of use of limits, etc.) and external environment (economy, market, etc.), including for important group companies (within a scope which does not conflict with laws, regulations, etc.), based on Asset Investment Risk Management Policy and the Asset Investment Risk Management Rules? Does it also monitor the status of the internal environment and external environment, as well as validity of assumptions, etc.? (2) Monitoring the Status of Compliance with Limits Does the Asset Investment Risk Management Division appropriately monitor the status of compliance and use of limits? (3) Reporting to Board of Directors or organization equivalent to the Board of Directors Based on Asset Investment Risk Management Policy and Asset Investment Risk Management Rules, does the Asset Investment Risk Management Division periodically or as needed report directly to the Board of Directors or organization equivalent to the Board of Directors, providing information enabling them to appropriately assess and judge the asset investment risk management situation and asset investment risk situation? For example, does
it report on the following matters?
periodically verify and revise whether it uses appropriate asset investment risk management methods which suit the entire insurance company’s strategic goals, size and characteristics of operations, and risk profile? For example, does it verify and revise the following matters?
Checkpoints
Market Risk Management System
See Attachment 1 regarding the market risk management system
Credit Risk Management System
See Attachment 2 regarding the credit risk management system
Real Estate Investment Risk Management System
(1) Establish Policy and Internal Rules, and Roles of the Board of Directors, for Real Estate Investment Risk Management (i) For real estate investment, is the Board of Directors fully aware that there are risks that changes in rental fees cause a decrease in real estate related earnings, and that changes in market conditions cause real estate prices themselves to decrease? In particular, is the director in charge aware of its characteristics that investment in real estate is generally a huge amount of investment, with very low liquidity, that earnings are uncertain and cannot be substituted, etc.? Based on this understanding, is he accurately aware of the insurance company’s real estate investment risk management situation, and does he investigate policies and specific actions for developing and establishing an appropriate real estate investment risk management system? (ii) Does the Board of Directors or organization equivalent to the Board of Directors establish real estate investment risk management policy (hereinafter referred to as “Real Estate Investment Risk Management Policy”), and inform the entire organization?
(iii) Does the Board of Directors or organization equivalent to the Board of Directors have the Manager of the real estate investment risk management division establish rules on real estate investment risk management (hereinafter referred to as “Real Estate Investment Risk Management Rules”)? Are the Real Estate Investment Risk Management Rules appropriate? For example, do they clearly write the following matters?
(ii) Does the Board of Directors or organization equivalent to the Board of Directors establish appropriate reporting matters, and provide a system for the Manager of the real estate risk management division to report on the situation of real estate investment risk management, periodically or as needed, to the Asset Investment Risk Management Division and the Board of Directors or organization equivalent to the Board of Directors? Does the Board of Directors or organization equivalent to the Board of Directors have the Manager of the real estate risk management division report appropriately on the situation of real estate which fell below the minimum investment yield or with unrealized loss exceeding the alarm point (hereinafter referred to as “Substandard Real Estate”), and of real estate with unrealized loss exceeding the alarm point and which is unused for a certain period and without a usage plan (hereinafter referred to as “Under-utilized Real Estate”), and describe investment use real estate of a certain size or larger which is reclassified into business use real estate? (iii) Does the Manager of the real estate investment risk management division provide an IT system12 for real estate investment risk management? (iv) To enable appropriate real estate investment risk management, does the Manager of the real estate investment risk management division thoroughly inform related staff about Real Estate Investment Risk Management Rules and operating procedures, by methods such as periodically providing guidance and training? (3) Points to Keep in Mind about Real Estate Investment Risk Management (i) Is the real estate investment risk management division appropriately aware of and does it understand risk factors faced by the insurance company (causes of changes in earnings, and causes of changes in real estate prices)? Does it appropriately manage them? (ii) Does the real estate investment risk management division check periodically or as needed, that classification as investment use real estate is in accordance with the Real Estate Investment Risk Management Rules? (iii) Does the real estate investment risk management division accurately collect, analyze and investigate information on the rental rate market, tenant supply and demand, land price trends, changes in land use regulations and taxation, relevant location conditions, competitive situation, environment (soil contamination, liquefaction, sinking, etc.), etc.?13 (iv) In screening real estate investments, does the real estate investment risk management division consider compliance with investment criteria, validity of business plan, portfolio (consideration of investment diversification), etc.? (v) Does the real estate investment risk management division appropriately manage investment
12 It should be noted that the computer system may be a centralized data processing environment system, distributed processing system, or end user computing (EUC) type. 13 If the real estate investment division collects, analyzes and investigates such information, the inspection will examine whether the real estate investment risk management division periodically or as needed checks the appropriateness and validity of results of information collection, analysis and investigation done by the real estate investment division.
real estate? For example: tenant recruiting, utilization ratio such as vacancy ratio, outsourcers, maintenance, projects underway, currency risks of overseas real estate, etc. Moreover, when a property falls below the minimum investment yield, is it reported to the Asset Investment Risk Management Division?14 (vi) Does the real estate investment risk management division calculate unrealized gain and losses of real estate, periodically or as needed? Also, is real estate assessment done appropriately by rational methods?15 (vii) Does the real estate investment risk management division especially strictly manage Substandard Real Estate, for example by having the real estate investment division investigate actions to obtain earnings? If the business plan for Substandard Real Estate is revised and there will be reinvestment, is this done after passing through screening by the real estate investment risk management division? Is the status of management of Substandard Real Estate (including designation as substandard, removal of designation, sale and disposability) reported to the Asset Investment Risk Management Division, and its appropriateness checked? (viii) Does the Asset Investment Risk Management Division investigate the possibilities of sale or disposal of Under-utilized Real Estate?16 Is the status of management of Under-utilized Real Estate (including investigation of status such as sale and disposal) reported to the Asset Investment Risk Management Division, and its appropriateness checked?
4. Asset Assessment, Write-off, and Reserves
Refer to Attachment (Checklist for Asset Assessment, Write-off, and Reserves)
14 If the real estate investment division is managing investment real estate, the inspection will examine whether the real estate investment risk management division periodically or as needed checks the appropriateness and validity of the status of management of investment real estate by the real estate investment division. 15 If the real estate investment division is calculating the unrealized gains and losses on real estate, the inspection will examine whether the real estate investment risk management division periodically or as needed checks the appropriateness and validity of the real estate unrealized gains and losses calculated by the real estate investment division. 16 If the real estate investment division investigates the possibilities of sale or disposal of Under-utilized Real Estate, the inspection will examine whether the real estate investment risk management division periodically or as needed checks the appropriateness and validity of the sale/disposal/holding policy created by the real estate investment division.
(Attachment 1)
I. Development and Establishment of Market Risk Management System by Management
Checklist
corresponding to the size and characteristics of the operation, risk profile, etc. “If…” indicates an item that the inspector should examine if the insurance company is using that management method or measurement technique, or if it is judged that it must be used.
“Market division” refers generally to divisions which handle market risks, among asset investment divisions. Note that this does not necessarily assume a specific division.
In creating the market division’s strategic goals, does it maintain consistency with the strategic goals of each operating area, consider the composition of assets and liabilities (including off balance sheet), as well as consider market and liquidity aspects, and the situation of equity, etc.? Also, does it consider, for example, the following items?
concerning market risk management (hereinafter referred to as the “Market Risk Management Rules”) and inform the organization, in accordance with the Market Risk Management Policy? Has the Board of Directors or organization equivalent to the Board of Directors approved the Market Risk Management Rules, after determining whether they comply with the Market Risk Management Policy and after legal checks, etc.? (2) Appropriate Setting of Limits Based on the Market Risk Management Policy and Market Risk Management Rules, does the Board of Directors or organization equivalent to the Board of Directors investigate the content of each division’s operations, then consider the positioning in each division in the business, equity, profitability, risk management ability, personnel abilities, insurance benefit payment ability, etc., and set appropriate limits (risk limit, position, limit, asset investment limit, etc.) to suit each type and risk category of operations and products handled?2 Also, does it compare business strength such as equity vs. market risk amount, to check that the market risk amount is not excessive from the aspect of business strength? For example, in setting limits, are the following matters considered?
There are “hard limits” which forcibly reduce positions and risks if the limit is exceeded, and “soft limits” which do not necessarily require forcibly reducing positions and risks and for which actions thereafter are discussed and decided by the Board of Directors or organization equivalent to the Board of Directors. The examination looks at whether limits are set appropriately to suit the actual transactions. When the Market Risk Management Division is not established as an independent division (e.g., when the division is consolidated with another risk management division to form a single division, or when a division in charge of other business also takes charge of market risk management, or when a Manager or Managers take charge of market risk management instead of a division or a department), the inspector shall review whether or not such a system is sufficiently reasonable and provides the same functions as in the case of establishing an independent division commensurate with the size and nature of the insurance company and its risk profile.
staff the authority necessary for conducting the aforementioned operations?4 (iv) Does the Board of Directors or organization equivalent to the Board of Directors keep the Market Risk Management Division independent from the asset investment division, Insurance Underwriting Division, etc., and secure a check-and-balance system of the Market Risk Management Division? (4) Development of Market Risk Management System in Asset Investment Division and Insurance Underwriting Division Through the Manager or Market Risk Management Division, does the Board of Directors or organization equivalent to the Board of Directors provide a system to ensure effectiveness of market risk management, such as by providing a system to inform the divisions involving market risks to be managed (e.g. Asset Investment Division, Insurance Underwriting Division, etc.) about the internal rules and operational procedures which must be observed, and to ensure that such divisions observe them? For example, does the Board of Directors or organization equivalent to the Board of Directors instruct the Manager to identify the internal rules and operational procedures that must be observed by the Asset Investment Division, Insurance Underwriting Division, etc., and to carry out specific actions for ensuring observance such as by providing effective training on a regular basis? (5) Development of System for Reporting to and Approval by the Board of Directors or organization equivalent to the Board of Directors Does the Board of Directors or organization equivalent to the Board of Directors appropriately specify matters that require reporting and those that require approval, and does it have the Manager report the status to the Board of Directors in a regular and timely manner or on an as needed basis, or have the Manager seek the approval of the Board of Directors? In particular, does it ensure that the Manager reports to the Board of Directors or organization equivalent to the Board of Directors without delay about matters that would seriously affect corporate management? (6) Development of System for Reporting to Corporate Auditor In the case that the Board of Directors has specified matters to be directly reported to a corporate auditor, has it specified such matters appropriately, and does it provide a system to have the Manager directly report such matters?5 (7) Development of Internal Audit Guidelines and Internal Audit Plan Does the Board of Directors or organization equivalent to the Board of Directors have the Internal Audit Division or Internal Audit Division Manager appropriately identify the matters
department or post, whether or not the structure of that deportment or post is reasonable in terms of a check-and-balance system and other aspects. It should be noted that this shall not preclude a corporate auditor from voluntarily seeking a report, and shall not
to be audited with regard to market risk management, develop guidelines that specify the matters subject to internal audit and the audit procedure (hereinafter referred to as “Internal Audit Guidelines”) and an internal audit plan, and approve such guidelines and plan?6 For example, does it have the following matters clearly specified in the Internal Audit Guidelines or the internal audit plan, and provide a system to have these matters appropriately audited?
It should be noted that the computer system may be a centralized data processing environment system, distributed processing system, or end user computing (EUC) type. Same hereinafter.
findings committees, etc. consisting of non-interested persons?
(2) Revision of Analysis and Assessment Processes Does the Board of Directors or organization equivalent to the Board of Directors revise the analysis and assessment processes in a timely manner, by reviewing their effectiveness based on reports and findings on the status of market risk management in a regular and timely manner or on an as needed basis?
2) Improvement Activities
(1) Implementation of Improvements
Does the Board of Directors or organization equivalent to the Board of Directors provide a system to implement improvements in the areas of the problems and weaknesses in the system, identified through the analysis, assessment and examination referred to in 3. 1) above, in a timely and appropriate manner based on the results obtained, by developing and implementing an improvement plan as required or by other appropriate methods? (2) Progress Status of Improvement Activities Does the Board of Directors or organization equivalent to the Board of Directors provide a system to follow up on the efforts for improvement in a timely and appropriate manner, by reviewing the progress status in a regular and timely manner or on an as needed basis? (3) Revision of Improvement Process Does the Board of Directors or organization equivalent to the Board of Directors revise the improvement process in a timely manner, by reviewing its effectiveness based on reports and findings on the status of market risk management, in a regular and timely manner or on an as needed basis?
II. Development and Establishment of Market Risk Management System by Manager
Checkpoints
Roles, responsibilities, and organizational framework of the Market Risk Management
Division, market division and Clerical Management Division
Identification of risks which should be subject to market risk management
Market risk measurement and analysis methods (techniques, assumptions, etc.)
Monitoring methods for market risks
Setting limits for market risks
Periodic verification of market risk measurement and analysis methods (techniques,
assumptions, etc.)
Current value calculations
Specified trading (if the insurance company establishes a specified trading account)
System for reporting to the Board of Directors or organization equivalent to the Board of
Directors
(3) Development of Organizational Framework by Manager (i) Based on the Market Risk Management Policy and Market Risk Management Rules, does the Manager provide for actions to have the Market Risk Management Division exercise a check-and-balance system, in order to conduct market risk management appropriately? (ii) Does the Manager provide a system which quickly reports to the Comprehensive Risk Management Division or Asset Investment Risk Management Division, if system weak points or problems are found which affect comprehensive risk management? (iii) Does the Manager understand the limitations and weak points of market risk measurement and analysis methods (techniques, assumptions, etc.), and provide a system for more advanced market risk management, such as greater scope and precision of market risk measurement which suits the size and characteristics of operations and the risk profile? (iv) Does the Manager provide a system in which the Market Risk Management Division can directly and appropriately obtain internal data and market data, such as required transaction information from the market division? Does he also provide a system which enables the Market Risk Management Division to directly command and supervise middle office operations, etc.? (v) Does the Manager provide a highly reliable IT system which can grasp all important market risks of that insurance company, and suits the size and characteristics of operations and its risk profile? (vi) Does the Manager ensure the provision of training and education systems to enhance the ability of employees to conduct market risk management in an effective manner, thus developing human resources with relevant expertise? (vii) Does the Manager provide a system to ensure that matters specified by the Board of Directors or organization equivalent to the Board of Directors are reported in a regular and timely manner or on an as needed basis? In particular, does the Manager provide a system to ensure that matters that would seriously affect corporate management are quickly reported to the Board of Directors or organization equivalent to the Board of Directors? (4) Revision of Market Risk Management Rules and Organizational Frameworks Does the Manager conduct monitoring on an ongoing basis, with regard to the status of the execution of operations at the Market Risk Management Division? Does the Manager review
the effectiveness of the market risk management system in a regular and timely manner or on an as needed basis, and, as necessary, revise the Market Risk Management Rules and the relevant organizational framework, or present proposals for improvement to the Board of Directors or organization equivalent to the Board of Directors?
2. Roles and Responsibilities of Market Risk Management Division
1) Identification and Assessment of Market Risks
(1) Identification of Market Risks
(i) Does the Market Risk Management Division bring to light the market risks faced by that insurance company? Considering the sizes and characteristics of the market risks brought to light, does it identify the market risks which should be subject to market risk management? When bringing these to light, does it ensure that this comprehensively covers the scope of operations, including risk categories (or risk factors) for interest rate risks, currency risks and price change risks for assets and liabilities (including off balance sheet), and overseas locations and important group companies? (ii) For risks held by that insurance company, are the following risks, for example, brought to light, and is it investigated whether these market risks should be managed? a. Interest Rate Risks Risk that changes in interest rates will affect present value (or period earnings) of assets and liabilities (including off balance sheet). As sources of interest rate risks, one must consider yield curve risk, basis risk and option risk. For example, the following assets have interest rate risks.
period earnings) of assets and liabilities (including off balance sheet). For example, the following have stock risks.
Instead of identifying these as market risks, these are identified as market transaction related credit risks in some cases. Vega risk is often classified as interest rate risk, currency risk, stock risk, commodity risk, etc., depending on the underlying asset. 10 Gamma risk is often classified as interest rate risk, currency risk, stock risk, commodity risk, etc., depending on the underlying asset.
(ii) Does the Market Risk Management Division measure present value (current price) of the position with a frequency which suits the size and characteristics of operations, as well as its risk profile? Also, are the greatest efforts made to obtain the current prices of items such as loans, for which there are no established techniques for obtaining current value? (iii) Does the Market Risk Management Division use appropriate market risk measurement and analysis methods (techniques, assumptions, etc.) which suit the size and characteristics of operations, as well as its risk profile? Also, are market risks measured and analyzed with consideration of both the factors which affect the present value of asset and liabilities (including off balance sheet), and the factors which affect period income? Note: Below are examples of techniques for measurement and analysis of market risks
Based on the Market Risk Management Policy and Market Risk Management Rules, does the Market Risk Management Division consider the situation of that insurance company’s internal environment (risk profile, situation of use of limits, etc.) and external environment (economy, market, etc.), and monitor the status of that insurance company’s market risks with at appropriate frequency? For example, for an insurance company with a strategy of making active market transactions, does the Market Risk Management Division monitor the positions and loss amounts of major instruments (including major instruments in the specified trading account) during the day as needed? Also, does it understand the portfolio status periodically or as needed? Does it monitor the status of the internal environment and external environment, and validity of assumptions? (2) Monitoring of Situation of Compliance with Limits Does the Market Risk Management Division appropriately monitor the status of compliance with and use of limits? For example, for an insurance company with a strategy of making active market transactions, does the Market Risk Management Division monitor the status of compliance with limits during the day as needed? Does it provide and appropriately operate a position earnings management IT system for each investment manager or each portfolio? (3) Reporting to the Board of Directors or organization equivalent to the Board of Directors Based on the Market Risk Management Policy and Market Risk Management Rules, does the Market Risk Management Division directly report periodically or as needed on the status of market risk management and the status of market risks, providing information enabling appropriate assessment and decisions by the Board of Directors or organization equivalent to the Board of Directors? For example, does it report on the following items?
shrink operations related to such risks?
(2) Response when Limits are Exceeded
When limits are exceeded, does the Market Risk Management Division quickly provide reports to the Board of Directors or organization equivalent to the Board of Directors, with information enabling it to decide whether to reduce positions, risks, etc.? (3) Portfolio Review Does the Market Risk Management Division provide a system for timely and appropriate review of the portfolio when securities are sold to provide liquidity, dividends or to cut losses.
4) Verification and Revision
(1) More Advanced Market Risk Management11
Does the Market Risk Management Division examine to understand the limitations and weak points of market risk measurement and analysis methods (techniques, assumptions, etc.), and take actions to supplement these methods? Also, considering these limitations and weak points, does the division investigate, analyze and study for advanced market risk management commensurate with the risk profile? (2) Revision concerning Identification of Market Risks Does the Market Risk Management Division periodically or as needed check whether risks which are not subject to market risk management have large effects, due to changes in the size and characteristics of operations as well as in its risk profile, and changes in the external environment (economy, market, etc.)? Also, if such effects are deemed large, are appropriate responses taken? (3) Revision of Market Risk Assessment Methods (i) Does the Market Risk Management Division verify whether its market risk measurement and analysis scope, frequency, techniques, etc. suit the size and characteristics of operations as well as it risk profile, periodically or as needed? If revisions are needed, are they made by appropriate procedures based on internal rules, etc.? (ii) Does the Market Risk Management Division theoretically and empirically verify the validity of and revise its pricing model, market risk measurement and analysis techniques, assumptions, etc., periodically or as needed? Also, does the Market Risk Management Division compare the market risk measurement results vs. the actual earnings trends, to verify the effectiveness of and revise its market risk measurement methods? (4) Revision of Limit Setting Methods and of Limits Set Does the Market Risk Management Division verify whether the limit setting methods and
11 It should be noted that sophistication of risk management includes not only expansion of scope of risk measurement and improvement in precision and other aspects of risk management, but also enhancement of actions to complement the limitations and weaknesses of the management and the technique of utilizing measurement results.
limits set suit the size and characteristics of operations as well as it risk profile, periodically or as needed? If revisions are found necessary, does it quickly report information enabling appropriate assessment and decisions by the Board of Directors or organization equivalent to the Board of Directors? (5) Revision of Strategic Goals Does the Market Risk Management Division compare its market risk measurement results vs. the actual earnings trends, to verify the validity of its risk/return strategy? Does the Market Risk Management Division report information required for revising strategic goals, to the Board of Directors or organization equivalent to the Board of Directors?
Checkpoints
instructions given for the areas of responsibility of investment managers? (iii) Are internal rules on limits strictly applied? Also, if problems are found in the internal rules or operation, are appropriate improvement actions taken? (4) Analysis of Profit/Loss Situation and Checking of Inappropriate Handling For settlement operations, is there economically irrational, unsound handling, using derivative transactions including purchases of structured bonds, etc.? Also, if the market division produces excessive earnings, does the Market Risk Management Division analyze its factors, and check whether it is due to inappropriate handling such as evasion of internal rules? Does the Market Risk Management Division inspect relations between contract amount, notional principle, transaction volume, etc.? (5) Communication and Reporting to the Market Risk Management Division Does the market division quickly and correctly communicate all market risk related information to the Market Risk Management Division? If problems occur in market risk management, is this quickly and correctly reported to the Market Risk Management Division, instead of being handled by the people in charge or within the market division? (6) Development of Checks and Balances Framework (i) If there is not unified administration of the IT systems of the market division, Market Risk Management Division and Clerical Management Division, does the Market Risk Management Division obtain position information, etc. from both the market division and the Clerical Management Division, and check that there are no inconsistencies in position information, etc.? (ii) Does the Market Risk Management Division obtain the staff required for monitoring transactions? (iii) Does the Market Risk Management Division periodically closely inspect and analyze to check whether there are abnormalities in the appearance of period profits (including unrealized gains and losses)? For example, does it examine by comparing against risk amounts? (iv) Are the following matters kept in mind for wielding a checks and balances function?
division, or is the same person serving as Manager of both the market division and Clerical Management Division?
operational procedures, etc.?
(ii) Comparisons of Transactions, Balances, etc.
Is transaction data in the market division compared against that in the Clerical Management Division for market transactions? If errors are found, is the cause found quickly, and is the data corrected based on previously established methods? For example, for securities transactions, are positions in the investment IT system of the market division compared periodically (at least once per year) against the balance (after checking) of securities held in accounts for the custody division and the financial instrument specialists in the Clerical Management Division?
2. Funds
1) Screening Management
(1) Decision Making Process
When purchasing, are fund characteristics and corresponding risks understood, and does it pass through a decision making process based on internal rules, etc.? For example, are these appropriately checked: fund’s structure, investment manager risks, liquidity risks, and limitations of that insurance company’s management methods? (2) Screening During Purchase In screening during purchase, are the following matters appropriately checked based on selection criteria?
2) Ongoing Risk Management
(1) Execution of Appropriate Risk Management
Is risk management performed with sufficient understanding of product characteristics and the actual status of funds, such as whether there are audits and long or short term contract cancellation periods? (2) Understanding of Investment Status Are investment reports, etc. used to verify and check whether investments are in accordance
with previously explained investment strategy and investment guidelines? Also, are investment style changes checked appropriately? In addition to held amounts, are commitment amounts also checked appropriately? (3) Obtaining Information Is there a contract maintained for information disclosure at an appropriate frequency, sufficient for risk management? Is it complied with?
3) Other
(1) Current Value Assessment
Is the validity of each element for deciding current value verified and checked? For example, methods of assessing fund investment assets, and other basic matters. (2) Risk Amount Measurement Are risk amounts measured appropriately, corresponding to fund characteristics? Also, if investment limits are set according to risk amounts, are the measured risk amounts within the range of limits set appropriately by considering business strengths such as equity?
3. Securitization Products
(1) Screening Management
During purchase, is there awareness and understanding of the characteristics and corresponding risks of securitization products, etc.? Do these pass through a decision making process based on internal rules? For example, are the following points appropriately understood and investigated? Also, if external ratings are used, is a system provided to avoid excessive reliance on external ratings? For example, are rating techniques and meanings of ratings of rating agencies accurately understood in advance?
securitization products, etc.)
12 Risk amount does not only refer to measurement by statistical techniques. It also includes techniques such as basis point value (BPV) and grid point sensitivity (GPS).
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Source: Financial Services Agency Japan — original document · Summary generated with machine assistance and reviewed before publication; the authoritative text is the regulator's original document. How RegAlert works
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