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印發(fā)《常州市農(nóng)業(yè)保險機構(gòu)監(jiān)測評價指導意見（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：20659 評論

導讀：按照《省政府辦公廳關(guān)于進一步完善農(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)保險機構(gòu)監(jiān)測評價指導意見(暫行)》印發(fā)你們，請各地結(jié)合實際參照實施。

　　【農(nóng)機網(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)保險機構(gòu)監(jiān)測評價指導意見(暫行)》印發(fā)你們，請各地結(jié)合實際參照實施。
 
　　附件：常州市農(nóng)業(yè)保險機構(gòu)監(jiān)測評價指導意見(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)保險機構(gòu)監(jiān)測評價指導意見(暫行)
 
　　按照《省政府辦公廳關(guān)于進一步完善農(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，為進一步提高農(nóng)業(yè)保險服務現(xiàn)代農(nóng)業(yè)發(fā)展的水平，建立政府對農(nóng)業(yè)保險機構(gòu)的剛性約束評價機制，現(xiàn)就農(nóng)業(yè)保險機構(gòu)監(jiān)測評價提出如下指導意見。如遇國家、省農(nóng)業(yè)保險政策重大調(diào)整，本《指導意見》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)務的主承保保險機構(gòu)和共保保險機構(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、保費補貼資金管理等法規(guī)政策，對農(nóng)業(yè)保險機構(gòu)開展監(jiān)測評價。
 
　　分級負責原則。市級農(nóng)業(yè)保險主管部門會同本級成員單位，負責農(nóng)險保險機構(gòu)監(jiān)測評價工作的指導與統(tǒng)籌，督促各地監(jiān)評結(jié)果反饋。各轄市(區(qū))農(nóng)業(yè)保險主管部門負責具體實施，承擔主體責任；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)辦機構(gòu)的監(jiān)評；也可以委托第三方機構(gòu)(會計師事務所)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、大災風險應對機制健全性、農(nóng)戶滿意度等重點領(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，服務管理情況。險種范圍。范圍為各級財政提供保費補貼的農(nóng)業(yè)保險險種，以及市或轄市(區(qū))財政提供保費補貼的改革試驗險種。時間區(qū)間。監(jiān)評時間區(qū)間為保險機構(gòu)經(jīng)辦農(nóng)業(yè)保險業(yè)務的整個工作年度，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。主承保機構(gòu)凡是虛報承保(理賠)標的，套取保費補貼資金，以理賠資金抵頂農(nóng)戶上繳保費，無故拒保，發(fā)生重大信訪或民生事件，視為當年度監(jiān)評不合格。對在我市農(nóng)業(yè)保險業(yè)務經(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。主承保機構(gòu)與共保機構(gòu)共同遵守共保協(xié)議內(nèi)相關(guān)權(quán)責約定，對無故履約不到位并產(chǎn)生嚴重后果的保險機構(gòu)給予通報，并納入不誠信保險機構(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。
 
　　2.有良好的農(nóng)業(yè)保險經(jīng)營戰(zhàn)略目標，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)健的大災風險應對和農(nóng)業(yè)再保險預案，建立完備的天氣預警、災害處置和防災救災機制。
 
　　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。
 
　　(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)代化省定目標相適應。
 
　　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)機設施等險種承保工作，業(yè)務規(guī)范，服務到位。農(nóng)戶承保信息單據(jù)完整、真實。
 
　　3.保單記載承保數(shù)量與實際承保標的一致，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，探索建立農(nóng)產(chǎn)品“基本險+大災險(補充險)+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)進行現(xiàn)場查勘。查勘的影像資料真實，單據(jù)完備，查勘報告要素齊全、內(nèi)容完整。定損標準和理賠方案符合《江蘇省農(nóng)業(yè)保險承保理賠操作規(guī)范》要求。
 
　　2.發(fā)生重大自然災害和養(yǎng)殖業(yè)重大疫病時，及時啟動應急處置預案，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，及時做好保費補貼資金結(jié)算。準確收繳農(nóng)戶應承擔的保費，做到不少繳、不多收。
 
　　3.建立本機構(gòu)巨災風險準備金，償付實力能應對重特大天氣自然災害和養(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)服務管理方面
 
　　1.市、轄市(區(qū))、鎮(zhèn)(街道)三級服務網(wǎng)絡體系完善?；鶎?鎮(zhèn)、街道)服務能力與該縣域農(nóng)業(yè)保險業(yè)務規(guī)模相匹配，合理配備農(nóng)險專員，并能掛牌服務，業(yè)務咨詢、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)務培訓。
 
　　3.按照《江蘇省農(nóng)業(yè)保險承保理賠檔案真實性、完整性標準指引》(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)務落實公示制度。承保理賠按比例落實回訪制度。每年度隨機開展服務問卷調(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)加強組織領(lǐng)導。農(nóng)業(yè)保險機構(gòu)監(jiān)評是對保險機構(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)保險機構(gòu)監(jiān)評，加強與同級成員單位對接和分工協(xié)作，共同部署好保險機構(gòu)的監(jiān)評工作。
 
　　(二)把握幾個環(huán)節(jié)。監(jiān)評時間上，各地應在每年一季度末(3月31日前)完成對保險機構(gòu)上年度的監(jiān)評工作，監(jiān)評結(jié)果及時報市備案。組織實施上，各地可以細化本地監(jiān)評指標和評分權(quán)重，制定符合當?shù)貙嶋H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)費安排上，各地可以與當?shù)剞r(nóng)業(yè)保險機構(gòu)協(xié)商，在保險機構(gòu)計提的管理費中列支。
 
　　(三)注重結(jié)果反饋。在主動公開保險機構(gòu)監(jiān)評結(jié)果的基礎上，各地農(nóng)業(yè)保險主管部門要加強監(jiān)評結(jié)果的反饋與運用，針對監(jiān)評中的不足，督導保險機構(gòu)查擺問題與原因，提出改進措施，不斷促進農(nóng)業(yè)保險市場可持續(xù)發(fā)展，提升農(nóng)業(yè)保險機構(gòu)保障“三農(nóng)”發(fā)展的水平。

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