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印發(fā)《常州市農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)測評價指導(dǎo)意見(暫行)》的通知

2019-12-07 09:01:23 來源:常州市農(nóng)業(yè)農(nóng)村局 財政局 閱讀量:20658 評論

導(dǎo)讀:按照《省政府辦公廳關(guān)于進(jìn)一步完善農(nóng)業(yè)保險經(jīng)營模式的通知》(蘇政辦發(fā)〔2018〕92號)和《關(guān)于進(jìn)一步完善全市農(nóng)業(yè)保險經(jīng)營模式的通知》(常政辦發(fā)〔2019〕7號)要求,現(xiàn)將《常州市農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)測評價指導(dǎo)意見(暫行)》印發(fā)你們,請各地結(jié)合實(shí)際參照實(shí)施。

  【農(nóng)機(jī)網(wǎng) 通知公告】各轄市(區(qū))農(nóng)業(yè)農(nóng)村局、財政局:
 
  按照《省政府辦公廳關(guān)于進(jìn)一步完善農(nóng)業(yè)保險經(jīng)營模式的通知》(蘇政辦發(fā)〔2018〕92號)和《關(guān)于進(jìn)一步完善全市農(nóng)業(yè)保險經(jīng)營模式的通知》(常政辦發(fā)〔2019〕7號)要求,現(xiàn)將《常州市農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)測評價指導(dǎo)意見(暫行)》印發(fā)你們,請各地結(jié)合實(shí)際參照實(shí)施。
 
  附件:常州市農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)測評價指導(dǎo)意見(暫行)
 
  常州市農(nóng)業(yè)農(nóng)村局          常州市財政局
 
  2019年12月2日
 
  (此件公開發(fā)布)
 
常州市農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)測評價指導(dǎo)意見(暫行)
 
  按照《省政府辦公廳關(guān)于進(jìn)一步完善農(nóng)業(yè)保險經(jīng)營模式的通知》(蘇政辦發(fā)〔2018〕92號)和《關(guān)于進(jìn)一步完善全市農(nóng)業(yè)保險經(jīng)營模式的通知》(常政辦發(fā)〔2019〕7號)要求,為進(jìn)一步提高農(nóng)業(yè)保險服務(wù)現(xiàn)代農(nóng)業(yè)發(fā)展的水平,建立政府對農(nóng)業(yè)保險機(jī)構(gòu)的剛性約束評價機(jī)制,現(xiàn)就農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)測評價提出如下指導(dǎo)意見。如遇國家、省農(nóng)業(yè)保險政策重大調(diào)整,本《指導(dǎo)意見》適時修訂完善。
 
  一、監(jiān)評對象
 
  監(jiān)評對象為經(jīng)政府采購在我市開展農(nóng)業(yè)保險業(yè)務(wù)的主承保保險機(jī)構(gòu)和共保保險機(jī)構(gòu)。
 
  二、基本原則
 
  依法依規(guī)原則。依據(jù)《農(nóng)業(yè)保險條例》、農(nóng)業(yè)保險險種條款、承保理賠操作規(guī)范、保費(fèi)補(bǔ)貼資金管理等法規(guī)政策,對農(nóng)業(yè)保險機(jī)構(gòu)開展監(jiān)測評價。
 
  分級負(fù)責(zé)原則。市級農(nóng)業(yè)保險主管部門會同本級成員單位,負(fù)責(zé)農(nóng)險保險機(jī)構(gòu)監(jiān)測評價工作的指導(dǎo)與統(tǒng)籌,督促各地監(jiān)評結(jié)果反饋。各轄市(區(qū))農(nóng)業(yè)保險主管部門負(fù)責(zé)具體實(shí)施,承擔(dān)主體責(zé)任;各地可以會同同級成員單位開展對本區(qū)域農(nóng)業(yè)保險經(jīng)辦機(jī)構(gòu)的監(jiān)評;也可以委托第三方機(jī)構(gòu)(會計師事務(wù)所)開展監(jiān)評。
 
  公平公開原則。突出承保理賠規(guī)范性、資金管理制度完善性、大災(zāi)風(fēng)險應(yīng)對機(jī)制健全性、農(nóng)戶滿意度等重點(diǎn)領(lǐng)域,公平、公正開展監(jiān)評工作,監(jiān)評結(jié)果及時向社會公開。
 
  三、制度安排
 
  監(jiān)評方向。主要包括五方面:政策貫徹情況,險種承保情況,定損理賠情況,資金管理情況,服務(wù)管理情況。險種范圍。范圍為各級財政提供保費(fèi)補(bǔ)貼的農(nóng)業(yè)保險險種,以及市或轄市(區(qū))財政提供保費(fèi)補(bǔ)貼的改革試驗(yàn)險種。時間區(qū)間。監(jiān)評時間區(qū)間為保險機(jī)構(gòu)經(jīng)辦農(nóng)業(yè)保險業(yè)務(wù)的整個工作年度,即每年1月1日至12月31日。評分等次。監(jiān)測評分采取百分制,根據(jù)評價得分(S)的分值,確定相應(yīng)的評價等次;共分為優(yōu)秀(S≥90)、良好(90>S≥75)、合格(75>S≥60)、不合格(S<60)四個評價等次。剛性罰則。主承保機(jī)構(gòu)凡是虛報承保(理賠)標(biāo)的,套取保費(fèi)補(bǔ)貼資金,以理賠資金抵頂農(nóng)戶上繳保費(fèi),無故拒保,發(fā)生重大信訪或民生事件,視為當(dāng)年度監(jiān)評不合格。對在我市農(nóng)業(yè)保險業(yè)務(wù)經(jīng)營活動中受到銀保監(jiān)部門處罰和通報,以及連續(xù)兩年在轄市(區(qū))級監(jiān)評得分在合格以下(S<75)的主承保機(jī)構(gòu),待市級成員單位會商并報銀保監(jiān)部門備案后,取消其下一輪在本市范圍內(nèi)開展農(nóng)業(yè)保險的資格。共保合作。主承保機(jī)構(gòu)與共保機(jī)構(gòu)共同遵守共保協(xié)議內(nèi)相關(guān)權(quán)責(zé)約定,對無故履約不到位并產(chǎn)生嚴(yán)重后果的保險機(jī)構(gòu)給予通報,并納入不誠信保險機(jī)構(gòu)名單。
 
  四、具體內(nèi)容
 
  (一)政策貫徹方面
 
  1.遵循國家、省、市等農(nóng)業(yè)保險法規(guī)政策,貫徹落實(shí)省、市農(nóng)業(yè)保險文件精神,執(zhí)行統(tǒng)一的險種條款,合規(guī)開展農(nóng)業(yè)保險業(yè)務(wù)。
 
  2.有良好的農(nóng)業(yè)保險經(jīng)營戰(zhàn)略目標(biāo),并符合政府“三農(nóng)”工作總體戰(zhàn)略部署,始終把取得“三農(nóng)”良好效益和社會利益擺在工作*。
 
  3.有穩(wěn)健的大災(zāi)風(fēng)險應(yīng)對和農(nóng)業(yè)再保險預(yù)案,建立完備的天氣預(yù)警、災(zāi)害處置和防災(zāi)救災(zāi)機(jī)制。
 
  4.能將農(nóng)業(yè)保險經(jīng)營收益積極回饋“三農(nóng)”發(fā)展,助力全市鄉(xiāng)村振興戰(zhàn)略發(fā)展和現(xiàn)代農(nóng)業(yè)建設(shè)。
 
  (二)險種承保方面
 
  1.農(nóng)業(yè)保險深度符合鄉(xiāng)村振興戰(zhàn)略總體部署;主要種植業(yè)保險承保面和高效農(nóng)業(yè)保險覆蓋面與農(nóng)業(yè)現(xiàn)代化省定目標(biāo)相適應(yīng)。
 
  2.結(jié)合農(nóng)業(yè)保險保單周期和農(nóng)時,在規(guī)定時間內(nèi)完成種植業(yè)、養(yǎng)殖業(yè)、農(nóng)機(jī)設(shè)施等險種承保工作,業(yè)務(wù)規(guī)范,服務(wù)到位。農(nóng)戶承保信息單據(jù)完整、真實(shí)。
 
  3.保單記載承保數(shù)量與實(shí)際承保標(biāo)的一致,無虛構(gòu)保險合同、虛報承保數(shù)量等方式騙取財政補(bǔ)貼資金的現(xiàn)象。
 
  4.根據(jù)地方政府要求,開展農(nóng)業(yè)保險創(chuàng)新型險種的改革試驗(yàn),探索建立農(nóng)產(chǎn)品“基本險+大災(zāi)險(補(bǔ)充險)+商業(yè)險”保障模式,能及時報省備案審批。
 
  (三)定損理賠方面
 
  1.接到農(nóng)戶報案后,在規(guī)定時間內(nèi)進(jìn)行現(xiàn)場查勘。查勘的影像資料真實(shí),單據(jù)完備,查勘報告要素齊全、內(nèi)容完整。定損標(biāo)準(zhǔn)和理賠方案符合《江蘇省農(nóng)業(yè)保險承保理賠操作規(guī)范》要求。
 
  2.發(fā)生重大自然災(zāi)害和養(yǎng)殖業(yè)重大疫病時,及時啟動應(yīng)急處置預(yù)案,能保持與政府之間聯(lián)動共商。
 
  3.農(nóng)業(yè)保險賠款一律直接賠付到被保險人銀行賬戶或農(nóng)戶“一折通”賬戶。
 
  4.未出現(xiàn)平均賠付、封頂賠付、拖賠惜賠等損害農(nóng)戶合法權(quán)益的現(xiàn)象。建立理賠投訴機(jī)制,理賠糾紛調(diào)處及時,未發(fā)生群體性重大矛盾糾紛。
 
  (四)資金管理方面
 
  1.農(nóng)業(yè)保險資金實(shí)行專戶管理,專賬核算,定向使用。
 
  2.按照財政部門要求上報承保理賠報表,數(shù)據(jù)全面真實(shí),及時做好保費(fèi)補(bǔ)貼資金結(jié)算。準(zhǔn)確收繳農(nóng)戶應(yīng)承擔(dān)的保費(fèi),做到不少繳、不多收。
 
  3.建立本機(jī)構(gòu)巨災(zāi)風(fēng)險準(zhǔn)備金,償付實(shí)力能應(yīng)對重特大天氣自然災(zāi)害和養(yǎng)殖業(yè)疫病。
 
  4.農(nóng)業(yè)保險資金管理使用過程中無違法違規(guī)行為。
 
  (五)服務(wù)管理方面
 
  1.市、轄市(區(qū))、鎮(zhèn)(街道)三級服務(wù)網(wǎng)絡(luò)體系完善?;鶎?鎮(zhèn)、街道)服務(wù)能力與該縣域農(nóng)業(yè)保險業(yè)務(wù)規(guī)模相匹配,合理配備農(nóng)險專員,并能掛牌服務(wù),業(yè)務(wù)咨詢、報案理賠渠道暢通。
 
  2.能做好農(nóng)業(yè)保險政策、險種、承保理賠流程的宣傳,投保農(nóng)戶對參保險種的主要內(nèi)容知曉度良好。能對基層農(nóng)險專員和鎮(zhèn)村協(xié)保員定期開展業(yè)務(wù)培訓(xùn)。
 
  3.按照《江蘇省農(nóng)業(yè)保險承保理賠檔案真實(shí)性、完整性標(biāo)準(zhǔn)指引》(蘇農(nóng)險辦發(fā)〔2018〕5號)要求,做好承保理賠的檔案歸檔工作。村(組)集體承保理賠業(yè)務(wù)落實(shí)公示制度。承保理賠按比例落實(shí)回訪制度。每年度隨機(jī)開展服務(wù)問卷調(diào)查,農(nóng)戶滿意度保持在90%以上。
 
  4.積極配合完成農(nóng)業(yè)保險主管部門部署的日常工作,及時報送各類報表、臺賬資料。
 
  五、監(jiān)評要求
 
  (一)加強(qiáng)組織領(lǐng)導(dǎo)。農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)評是對保險機(jī)構(gòu)年度工作的總體評價,是營造良好市場競爭環(huán)境,建立優(yōu)勝劣汰機(jī)制的具體手段。各轄市(區(qū))農(nóng)業(yè)保險主管部門要高度重視農(nóng)業(yè)保險機(jī)構(gòu)監(jiān)評,加強(qiáng)與同級成員單位對接和分工協(xié)作,共同部署好保險機(jī)構(gòu)的監(jiān)評工作。
 
  (二)把握幾個環(huán)節(jié)。監(jiān)評時間上,各地應(yīng)在每年一季度末(3月31日前)完成對保險機(jī)構(gòu)上年度的監(jiān)評工作,監(jiān)評結(jié)果及時報市備案。組織實(shí)施上,各地可以細(xì)化本地監(jiān)評指標(biāo)和評分權(quán)重,制定符合當(dāng)?shù)貙?shí)際的監(jiān)測評價表,確保監(jiān)評工作具有量化性、可操作性。經(jīng)費(fèi)安排上,各地可以與當(dāng)?shù)剞r(nóng)業(yè)保險機(jī)構(gòu)協(xié)商,在保險機(jī)構(gòu)計提的管理費(fèi)中列支。
 
  (三)注重結(jié)果反饋。在主動公開保險機(jī)構(gòu)監(jiān)評結(jié)果的基礎(chǔ)上,各地農(nóng)業(yè)保險主管部門要加強(qiáng)監(jiān)評結(jié)果的反饋與運(yùn)用,針對監(jiān)評中的不足,督導(dǎo)保險機(jī)構(gòu)查擺問題與原因,提出改進(jìn)措施,不斷促進(jìn)農(nóng)業(yè)保險市場可持續(xù)發(fā)展,提升農(nóng)業(yè)保險機(jī)構(gòu)保障“三農(nóng)”發(fā)展的水平。
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