GB/T 43568-2023 in English
VALIDSpecification of insurance consumer complaints handling
- Issued on:2023-12-28
- Implemented on:2024-04-01
- File Format:PDF
- Delivery:Via email within 5 business days
$359.00
| Standard No: | GB/T 43568-2023 |
| Document status: | VALID |
| Title in English: | Specification of insurance consumer complaints handling |
| Title in Chinese: | 保险消费投诉处理规范 |
| Language: | English |
| File Format: | Electronic (PDF) |
| Delivery: | Via email within 5 business days |
| Issued on: | 2023-12-28 |
| Implemented on: | 2024-04-01 |
| Professional Classification: | GB-National Standard |
| Related Keywords: | complaint handling
complaint handling responsibility accountability mechanism complaint handling management measures insurance consumer complaints internet insurance |
| Related Topics: | Insurance
who to complain complaint zero complaints The first set of complaints Fee management fee Peak elimination Environmental appeal risk fee standard sue again Grading Complaint Handling Mechanism Code of Regulations on Complaint Handling of Insurance Institutions |
《GB/T 43568-2023保险消费投诉处理规范》由TC180（全国金融标准化技术委员会）归口，TC180SC1（全国金融标准化技术委员会保险分会）执行，主管部门为中国人民银行。
Introduction
Interpretation of the core framework of the standard
| Modules | Main content | Innovation points |
|---|---|---|
| Overall requirements | 6 basic principles: principal responsibility, fairness and rationality, timeliness and efficiency, conflict of interest avoidance, information confidentiality, and diversified resolution | For the first time, it is clearly required to establish a "complaint handling conflict of interest avoidance mechanism" |
| Organizational management | Three major systems: institutional mechanism, personnel allocation, and resource guarantee | Requires the configuration of complaint handling information system and recording and video equipment |
| Processing process | 7 standard steps: submit → register → investigate → negotiate → inform → verify → archive | Electronic complaint withdrawal mechanism (terminate on the same day) |
Analysis of the complaint classification system
Standard Appendix A establishes a five-level coding system (category → major category → medium category → minor category), covering the entire life cycle of sales, underwriting, claims settlement, etc.:
- Sales link (code starting with 1): subdivided into relationship building (11101 telephone communication), product sales (12101 notification of terms), etc.
- Claims link (code starting with 5): includes 12 subcategories such as reporting (51101 missed call) and damage assessment (53101 amount dispute)
- Special scenarios: Internet insurance is marked separately (such as 1207 electronic policy service)
Implementation suggestions
Key points of system construction
- Establish a complaint tracing and rectification mechanism: form a closed loop from complaint → problem identification → rectification → evaluation
- Improve the evaluation system: include complaint handling in the KPI assessment of institutions at all levels
- Allocate special resources: It is recommended that the ratio of complaint handling posts to service personnel be no less than 1:50
Process optimization direction
| Pain points | Standard requirements | Solutions |
|---|---|---|
| Untimely response | 4.3 Principle of timeliness and efficiency | Establish an intelligent work order system for automatic allocation + timeout warning |
| Opaque processing | 5.1 Information disclosure mechanism | Official website publishes complaint handling flow chart + average processing time |
Analysis of standard evolution
Compared with the original "Complaint Handling Management Measures" (2020) of the China Insurance Regulatory Commission, this standard:
- Degree of refinement: The classification of complaint reasons is expanded from 3 levels to 5 levels of coding
- Technical adaptation: New digital scenario specifications such as Internet insurance and electronic insurance policies
- Responsibility reinforcement: Clearly requires the establishment of a "complaint handling responsibility accountability mechanism" (Article 5.1.6)
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