XX财产保险公司内部控制手册（120页）.rar

财产保险有限公司
内部控制手册
XX
I
目录
一、手册概述 Preface..................................................................................................1
1.1内部控制定义..................................................................................................1
1.2内部控制手册内容..........................................................................................1
1.3内部控制手册遵循性要求..............................................................................1
1.4颁布及生效日期..............................................................................................1
二、控制环境 Control Environment(CE)............................................................................................................2
2.1公司治理结构(CE01)......................................................................................2
2.1.1治理方针(CE01-01)..............................................................................2
2.1.2股东大会(CE01-02)..............................................................................3
2.1.3董事会(CE01-03)..................................................................................3
2.1.4监事会(CE01-04)..................................................................................4
2.1.5风险管理委员会(CE01-05)..........................................................................................................4
2.1.6投资决策委员会(CE01-06)..........................................................................................................4
2.1.7提名与薪酬委员会(CE01-07)......................................................................................................5
2.1.8审计委员会(CE01-08)..................................................................................................................5
2.1.9内部审计(CE01-09)..............................................................................6
2.1.10信访机构(CE01-10)............................................................................6
2.1.11法律事务(CE01-11)............................................................................7
2.2组织机构设置(CE02)......................................................................................8
2.2.1信息流通(CE02-01)..............................................................................8
2.2.2职责认知(CE02-02)..............................................................................8
2.2.3胜任能力(CE02-03)..............................................................................9
2.2.4报告关系(CE02.04)..............................................................................9
2.3决策机制(CE03)............................................................................................10
2.3.1股东大会的决策职权(CE03-01)................................................................................................10
2.3.2董事会的决策职权(CE03-02).....................................................................................................11
2.3.3 经营决策(CE03-03).............................................................................11
2.3.4
决策评估评价机制(CE03-04)....................................................................................................12
2.4人力资源政策和措施(CE04) ................................................................................................................12
2.4.1 聘用
(CE04-01)....................................................................................13
2.4.2 培训
(CE04-02)....................................................................................13
2.4.3
晋升(CE04-03)....................................................................................14
2.4.4激励(CE04-04)....................................................................................14
2.4.5管理(CE04-05)....................................................................................15
2.5经营理念和营运模式(CE05)................................................................................................................15
2.5.1岗位轮换(CE05-01)............................................................................16

II
2.5.2对待数据处理和会计职能的态度(CE05-02)............................................................................16
2.5.3高层管理人员与基层的交流(CE05-03)....................................................................................16
2.5.4对财务报告相关事务的态度和采取的行动(CE05-04)............................................................17
2.6员工胜任能力(CE06)....................................................................................17
2.6.1对所需能力的分析(CE06-01)....................................................................................................18
2.6.2员工的数量和能力(CE06-02)....................................................................................................18
2.7权责的划分(CE07)........................................................................................18
2.7.1岗位职责的描述(CE07-01)........................................................................................................19
2.7.2职权和职责的分解(CE07-02)....................................................................................................19
2.7.3权责的分配(CE07-03)................................................................................................................19
2.8诚信和道德观(CE08)....................................................................................20
2.8.1员工行为准则(CE08-01)............................................................................................................20
2.8.2对总裁和董事行为准则和道德规范的修改或废止(CE08-02)................................................21
2.8.3行为准则和道德规范的披露(CE08-03)....................................................................................21
2.8.4管理理念(CE08-04)............................................................................21
2.8.5兼顾各方利益原则(CE08-05)....................................................................................................22
2.8.6对违规行为的处理(CE08-06)....................................................................................................22
2.8.7端正管理层干涉正常程序或凌驾制度的行为(CE08-07)........................................................23
三、风险评估Risk Assessment(RA)...........................................................................23
3.1公司目标(RA01)............................................................................................24
3.1.1公司战略目标确定(RA01-01)....................................................................................................24
3.1.2经营管理目标确定(RA01-02)....................................................................................................24
3.1.3公司目标传递(RA01-03)............................................................................................................25
3.2风险识别(RA02)............................................................................................25
3.2.1风险识别范围(RA02-01)............................................................................................................26
3.2.2风险识别方法(RA02-02)............................................................................................................26
3.3风险处理(RA03)............................................................................................27
3.3.1风险分析与评估(RA03-01)........................................................................................................27
3.3.2 风险应对措施(RA03-02)............................................................................................................28
3.3.3评估应对措施的执行(RA03-04)................................................................................................29
3.4风险监控(RA04)............................................................................................29
3.4.1 风险跟踪
(RA04-01)............................................................................30
3.4.2突发风险应对(RA04-03)............................................................................................................30
3.5风险信息收集与汇报(RA05)................................................................................................................30
四、财务会计控制活动Finance and Accounting Control Activities(FA)...........................................................31
4.1财务管理体制(FA01).....................................................................................31
4.1.1财务机构设置(FA01-01)............................................................................................................31
4.1.2预算管理体制(FA01-02)............................................................................................................32

III
4.1.3分级分类考核机制(FA01-03)....................................................................................................32
4.2财务监督体制(FA02).....................................................................................33
4.3财务处理系统(FA03).....................................................................................33
4.4财务信息报告(FA04).....................................................................................34
4.5会计基础管理(FA05).....................................................................................34
4.5.1岗位制约(FA05-01)............................................................................35
4.5.2会计记录及处理(FA05-02)........................................................................................................35
4.5.3会计档案及其他要件管理(FA05-03)........................................................................................36
4.6收入管理(FA06).............................................................................................37
4.6.1保费收入(FA06-01)............................................................................37
4.6.2投资收入及利息收入(FA06-02)................................................................................................37
4.6.3营业外收入(FA06-03)................................................................................................................38
4.7支出管理(FA07).............................................................................................38
4.7.1各项业务支出(FA07-01)............................................................................................................38
4.7.2营业外支出(FA07-02)................................................................................................................39
4.7.3手续费支出(FA07-03)................................................................................................................39
4.7.4营业费用(FA07-04)............................................................................40
4.8负债管理(FA08).............................................................................................40
4.8.1负债评估(FA08-01)............................................................................40
4.8.2其他负债项目(FA08-02)............................................................................................................41
4.9偿付能力管理(FA09).....................................................................................42
4.10资产管理(FA10)...........................................................................................42
4.10.1固定资产管理(FA10-01)..........................................................................................................42
4.10.2物业投资项目控制(FA10-02)..................................................................................................43
4.10.3低值易耗品(FA10-03)..............................................................................................................44
4.10.4长期待摊费用(FA10-04)..........................................................................................................44
4.11股东权益(FA11)...........................................................................................45
4.11.1股本(FA11-01)...................................................................................45
4.12往来款结算(FA12).......................................................................................45
4.12.1应收款及预付款项(FA12-01)..................................................................................................45
4.12.2 其他应付款
(FA12-02)..............................................................................................................46
4.13税务管理(FA13)...........................................................................................46
4.13.1 申报
(FA13-01)..................................................................................47
五、资金控制活动Capital Control Activities(CC).............................................................................................47
5.1资金管理体制(CC01)....................................................................................47
5.2资金监控体制(CC02)....................................................................................48
5.3资金运用决策(CC03)....................................................................................48
5.3.1投资指引(CC03-01)............................................................................48

IV
5.3.2权限管理(CC03-02)............................................................................49
5.3.3投资分析(CC03-03)............................................................................49
5.4投资资金管理(CC04)....................................................................................50
5.5资金效益(CC05)............................................................................................50
5.5.1保费的及时到账(CC05-01)........................................................................................................50
5.5.2未达账的管理(CC05-02)............................................................................................................51
5.5.3收入账户控制(CC05-03)............................................................................................................51
5.5.4各种挂账(CC05-04)............................................................................52
5.5.5充分的资金运用(CC05-05)........................................................................................................52
5.6现金流控制(CC06)........................................................................................52
5.6.1应收保费管理(CC06-01)............................................................................................................52
5.6.2收入账户资金定期、定额控制(CC06-02)................................................................................53
5.6.3专项资金控制(CC06-03)............................................................................................................53
5.6.4网络结算(CC06-04)............................................................................54
5.6.5各种应收款项的定期清理(CC06-05)........................................................................................54
5.6.6已支付未入账资金清理(CC06-06)............................................................................................54
5.6.7应付未付款项确认(CC06-07)....................................................................................................55
5.6.8保险资金与投资运用资金的相互对应(CC06-08)....................................................................55
5.7资金调拨、划转(CC07)................................................................................56
5.7.1周转金限额控制(CC07-01)........................................................................................................56
5.8现金控制(CC08)............................................................................................56
5.8.1现金收费(CC08-01)............................................................................57
5.8.2其他现金收入(CC08-02)............................................................................................................57
5.8.3业务的现金支出(CC08-03)........................................................................................................58
5.8.4费用及其他现金支出(CC08-04)................................................................................................58
5.8.5备用金管理(CC08-05)................................................................................................................59
5.9银行存款(CC09)............................................................................................59
5.9.1银行代理业务收费(CC09-01)....................................................................................................59
5.9.2银行账的对账与余额调解表编制(CC09-02)............................................................................60
5.9.3印章的管理(CC09-03)................................................................................................................60
5.9.4
账户设置(CC09-04)............................................................................61
六、业务控制活动Business Operation Control Activities(BO).........................................................................61
6.1业务管理体制(BO01)....................................................................................61
6.2业务监督体制(BO02)....................................................................................61
6.3业务处理系统(BO03)....................................................................................62
6.4产品开发(BO04)............................................................................................62
6.4.1市场信息收集、整理和分析(BO04-01)....................................................................................63
6.4.2产品开发新创意的提出(BO04-02)............................................................................................63
V
6.4.3产品设计(BO04-03)............................................................................64
6.4.4费率厘定(BO04-04)............................................................................64
6.4.5产品论证(BO04-05)............................................................................64
6.4.6产品报备(BO04-06)............................................................................65
6.4.7产品下发(BO04-07)............................................................................65
6.4.8产品跟踪(BO04-08)............................................................................65
6.5销售管理(BO05)............................................................................................66
6.5.1营销员管理(BO05—01).............................................................................................................68
6.5.2业务员管理(BO05-02)................................................................................................................66
6.5.3中介管理(BO05-03)............................................................................67
6.5.4交叉业务管理(BO05-04)............................................................................................................69
6.6保单合同管理(BO06)....................................................................................69
6.6.1展业(BO06-01)....................................................................................68
6.6.2接单初审与投保资料录入(BO06-02)........................................................................................69
6.7核保（BO07）..............................................................................................70
6.7.1 核保审核(BO07-01)...........................................................................70
6.7.2核保权限管理(BO07-02)............................................................................................................71
6.7.3核保人员及岗位管理(BO07-03)................................................................................................71
6.8理赔管理(BO08)............................................................................................72
6.8.1理赔权限管理(BO08-01)............................................................................................................72
6.8.2理赔人员及岗位管理(BO08-02)................................................................................................73
6.8.3理赔调查(BO08-03）.................................................................................................................73
6.8.4代查勘(BO08-04)................................................................................74
6.8.5理赔理算(BO08-05)............................................................................75
6.8.6预付赔款(BO08-06)............................................................................75
6.8.7赔案复核审批(BO08-07)............................................................................................................76
6.8.8结案(BO08-08)....................................................................................77
6.9保单批改管理(BO9)......................................................................................77
6.10收付费管理(BO10)......................................................................................78
6.10.1收付操作、收付费岗位管理(BO10-01)..................................................................................78
6.10.2
收付费单据的审核与到账确认(BO10-02)..............................................................................79
6.10.3
收付费真实性(BO10-03)..........................................................................................................79
6.11 单证管理
(BO11)..........................................................................................80
6.11.1单证印刷(BO11-01)..................................................................................................................80
6.11.2单证入库(BO11-02)..................................................................................................................80
6.11.3单证领用／发放(BO11-03)......................................................................................................81
6.11.4重要、有价单证回销(BO11-04)..............................................................................................81
6.11.5重要、有价单证销毁(BO11-05)..............................................................................................82
VI
6.11.6对已停止使用的重要空白单证的管理(BO11-06)..................................................................82
6.11.7单证库房管理(BO11-07)..........................................................................................................83
6.12客户回访及咨询投诉(BO12)..............................................................................................................83
6.13再保险(BO13)..............................................................................................84
6.13.1再保险部门及岗位设置(BO13-01)..........................................................................................84
6.13.2商业分保 (BO13-02)..............................................................................................................85
6.13.3风险评估与计算(BO13-03)......................................................................................................85
6.13.4自留额(BO13-04)..............................................................................85
6.13.5再保赔款及手续费(BO13-05)..................................................................................................86
6.13.6分入业务(BO13-06)..................................................................................................................86
6.13.7再保业务统计(BO13-07)..........................................................................................................87
6.13.8再保业务账单(BO13-08)..........................................................................................................87
6.14业务档案管理(BO14)..................................................................................87
七、信息技术控制活动Information System Control Activities (IT)...............................................................88
7.1职责划分(IT01)..............................................................................................89
7.2应用系统开发(IT02)......................................................................................89
7.3应用系统维护(IT03)......................................................................................90
7.3.1应用系统修改(IT03-01).............................................................................................................90
7.3.2软件系统上线(IT03-02).............................................................................................................90
7.3.3安全管理(IT03-03).............................................................................91
7.4操作系统与数据库维护(IT04)..............................................................................................................91
7.4.1监控(IT04-01).....................................................................................91
7.4.2系统参数修改(IT04-02) .............................................................................................................92
7.4.3数据修改(IT04-03).............................................................................92
7.4.4数据库结构变更(IT04-04) .........................................................................................................93
7.4.5数据备份(IT04-05).............................................................................93
7.4.6 安全管理(IT04-06) .............................................................................94
7.4.7病毒防范(IT04-07) .............................................................................94
7.5网络管理(IT05)..............................................................................................95
7.5.1 监控(IT05-01) .....................................................................................95
7.5.2
网络故障维护(IT05-02).............................................................................................................95
7.5.3
网络安全(IT05-03).............................................................................96
7.6
机房设备管理(IT06)......................................................................................96
7.6.1机房管理(IT06-01).............................................................................96
7.6.2设备购置(IT06-02).............................................................................97
7.6.3设备维修(IT06-03).............................................................................97
7.6.4设备的处置和设备的再利用(IT06-04)......................................................................................98
7.6.5设备档案管理(IT06—05)...........................................................................................................98
VII
7.7应急计划(IT07)..............................................................................................99
7.8档案管理(IT08)..............................................................................................99
八、信息和沟通Information and Communication(IC).....................................................................................100
8.1信息系统(IC01)...........................................................................................100
8.1.1信息收集(IC01-01)...........................................................................100
8.1.2信息处理和报告(IC01-02).......................................................................................................101
8.1.3信息系统建设 (IC01-03).........................................................................................................102
8.2沟通(IC02)...................................................................................................102
8.2.1员工职责及其控制责任的沟通(IC02-01)...............................................................................102
8.2.2员工反映特殊信息的渠道(IC02-02).......................................................................................103
8.2.3管理层对员工合理化建议的态度(IC02-03)...........................................................................103
8.2.4公司内部沟通的充分性(IC02-04)...........................................................................................104
8.2.5与客户就产品需求、服务进行沟通(IC02-05).......................................................................104
8.2.6对外宣传公司品牌(IC02-06)...................................................................................................105
8.2.7危机事件管理(1C02-07)...........................................................................................................105
8.2.8对外披露(IC02-08)...........................................................................106
九、内部监督Monitoring(MO).................................................................................106
9.1监督机制(MO01).........................................................................................106
9.2监督活动(MO02).........................................................................................107
9.2.1日常监督(MO02-01).................................................................................................................107
9.2.2监督形式与手段(MO02-02).....................................................................................................108
9.2.3项目实施(MO02-03).................................................................................................................108
9.3自我评估(MO03).........................................................................................109
9.3.1自我评估的范围和频率(MO03-01).........................................................................................109
9.3.2评估过程方法(MO03-02)..........................................................................................................110
9.3.3评估记录(MO03-03)..................................................................................................................110
9.4持续改进(MO04)..........................................................................................110
9.4.1缺陷报告机制(MO04-01)..........................................................................................................111
9.4.2后续监督(MO04-02)..................................................................................................................111