Regulations Governing Implementation of Internal Control and Auditing System of Insurance Enterprises Article 5
An insurance enterprise shall, based on its business nature and scale, establish operating procedures for at least the following control operations according to the principles of internal check, and review and revise such procedures in a timely manner:1.Insurance product development and management operation: Including risk assessment of insurance products, evaluation of premium rate adequacy, assessment of reserve adequacy and the product management operation.2.Product sales operation: Including promotional materials and information to be disclosed in insurance policy, business solicitation, underwriting, contract conversion, reinstatement, conservation, fees and charges.3.Claim operation: Including investigation of accident, review and payment operation.4.Fund utilization operation: Including holistic investment policies, acquisition, custody and disposal of various investment assets, and rules for related party transactions.5.Solvency assessment operation: Including assessment of provisions for various kinds of reserves, evaluation of asset quality, the match of assets and liabilities, resolution of overdue loans and non-accrual loans, management of investment and fund liquidity, assessment of financial conditions and capital adequacy, insurance enterprise risk management and assessment of the insurance enterprise’s self risks and solvency.6.Processing derivatives transactions operation: Including trading principles and guidelines, operating procedures, announcement and reporting procedures, accounting treatment, internal control and audit system.7.Reinsurance operation: Including methods of reinsurance, assessment of risks and risk tolerance, reinsurance retention ratio and selection of reinsurers and reinsurance brokers.8.Control operations of accounting, general affairs, resources, personnel management and other businesses.9.Management of financial examination reports.10.Management of financial consumers protection.11.Management of the application of International Financial Reporting Standards.12.Mechanism for handling major contingencies.13.Mechanism for anti-money laundering and combating the financing of terrorism (AML/CFT) and management of compliance with relevant laws and regulations, including the management mechanism for identifying, assessing, and monitoring AML/CFT risks.14.Management of sustainability information15.Other matters designated by the competent authority.Where an insurance enterprise is required to establish a remuneration committee according to law, the insurance enterprise shall design internal controls and operating procedures for the operation and management of the remuneration committee.Where an insurance enterprise has an audit committee established, its internal control system shall also include the management of the audit committee meeting procedures.For the stipulation, revision or abolition of all operational and management regulations mentioned in the preceding three paragraphs, it requires the participation of regulatory compliance, internal audit, and risk management agencies.
中文原文 保險業內部控制及稽核制度實施辦法第5條
保險業應分別業務性質及規模，依內部牽制原理訂定至少應包括下列控制作業之處理程序，且應適時檢討修訂：
一、保險商品開發及管理作業：包括保險商品之風險評估、費率適足性之評估、準備金充分性之評估及商品管理作業。
二、保險商品銷售作業：包括文宣及保單揭露事項、招攬、核保、契約轉換、復效、保全、收費。
三、保險商品理賠作業：包括事故調查、審核、付款作業。
四、各種資金運用作業：包括整體性投資政策、各種投資資產之取得、保管、處分及利害關係人交易規範。
五、清償能力評估作業：包括各種準備金提存之評估、資產品質之評估、資產與負債配合、逾期放款、催收款之清理、投資與資金之流動性管理、財務狀況評估及資本適足之評估、保險業企業風險管理、保險業自我風險及清償能力評估。
六、從事衍生性金融商品作業：包括交易原則與方針、作業程序、公告申報程序、會計處理方式、內部控制與稽核制度。
七、再保險作業：包括再保險方式、各種風險及承受風險之評估，再保險自留限額及再保險人、再保險經紀人之選擇。
八、關於會計、總務、資源、人事管理及其他各種業務之控制作業。
九、金融檢查報告之管理。
十、金融消費者保護之管理。
十一、適用國際財務報導準則之管理。
十二、重大偶發事件之處理機制。
十三、防制洗錢及打擊資恐機制及相關法令之遵循管理，包括辨識、衡量、監控洗錢及資恐風險之管理機制。
十四、永續資訊之管理。
十五、其他經主管機關指定之事項。
另依法應設置薪資報酬委員會之保險業，應設計薪資報酬委員會運作管理之內部控制作業處理程序。
保險業設置審計委員會者，其內部控制制度，應包括審計委員會議事運作之管理。
前三項各種作業及管理規章之訂定、修訂或廢止，必要時應有法令遵循、內部稽核及風險管理單位等相關單位之參與。
一、保險商品開發及管理作業：包括保險商品之風險評估、費率適足性之評估、準備金充分性之評估及商品管理作業。
二、保險商品銷售作業：包括文宣及保單揭露事項、招攬、核保、契約轉換、復效、保全、收費。
三、保險商品理賠作業：包括事故調查、審核、付款作業。
四、各種資金運用作業：包括整體性投資政策、各種投資資產之取得、保管、處分及利害關係人交易規範。
五、清償能力評估作業：包括各種準備金提存之評估、資產品質之評估、資產與負債配合、逾期放款、催收款之清理、投資與資金之流動性管理、財務狀況評估及資本適足之評估、保險業企業風險管理、保險業自我風險及清償能力評估。
六、從事衍生性金融商品作業：包括交易原則與方針、作業程序、公告申報程序、會計處理方式、內部控制與稽核制度。
七、再保險作業：包括再保險方式、各種風險及承受風險之評估，再保險自留限額及再保險人、再保險經紀人之選擇。
八、關於會計、總務、資源、人事管理及其他各種業務之控制作業。
九、金融檢查報告之管理。
十、金融消費者保護之管理。
十一、適用國際財務報導準則之管理。
十二、重大偶發事件之處理機制。
十三、防制洗錢及打擊資恐機制及相關法令之遵循管理，包括辨識、衡量、監控洗錢及資恐風險之管理機制。
十四、永續資訊之管理。
十五、其他經主管機關指定之事項。
另依法應設置薪資報酬委員會之保險業，應設計薪資報酬委員會運作管理之內部控制作業處理程序。
保險業設置審計委員會者，其內部控制制度，應包括審計委員會議事運作之管理。
前三項各種作業及管理規章之訂定、修訂或廢止，必要時應有法令遵循、內部稽核及風險管理單位等相關單位之參與。