Ref.
1. Obtain and review the underwriting guidelines and procedures to
ensure the Company is in line with the guidelines on standards of
sound business and financial practices for Life Insurance Companies.
The u/w and liability policies need to contain the following:
• U/W and liability philosophy (including principles to address the
use of reinsurance and alternative approach)
• description of groups of individuals and/or other classifications
which is prepared to u/w, or is restricted from underwriting
• clearly defined and appropriate levels of delegation of approval
• sound and prudent concentration limits.
• that each analyst has access to the underwriting manuals and guidelines
Select a random sample of 25 policies (over the last 2 months) and
review to confirm that underwriting policies and procedures were
followed. The sample should include all lines of business
2. Determine if documented service standards exist for processing of
underwriting files and for CSI. Verify that:
• these are communicated to the staff
• standards are monitored regularly by management
• evidence that the area is meeting its standards, if not document
reasons for non-compliance
3. Discuss with mgmt the manner in which productivity/performance of
the department is monitored and evaluated. Inquire about any negative
trends, and action taken to address them. Specificially review for:
• Volume of business received / processed
• Approvals and declines
• Follow-up of pending file is adequate
• Verify these reports are forwarded to exec management for review
4. Determine the current process in place for the follow-up of files
requiring information/investigation.
Assess adequacy of the process and review the follow-up queues for
actions taken.
5. Obtain and review the documented procedures for conducting quality
assurance reviews of staff.
6. Assess whether the quality review process is adequate including:
• adequate sample of files/analysts,
• frequency of reviews,
• review includes all functions
• results are tracked to allow for identifying trends
• issues of concern reviewed with analyst audited
• trending reports reviewed to evaluate progress of the underwriters
7. If there are any current agency staff, verify that they are QC'ed
more frequently.
8. Obtain a list of staff QC'ed for the previous 2 months, and verify
that each individual was reviewed.
9. Take a sample of QAR's (one for each staff) and confirm completion.
10. Verify that the results of QAR's are reported to management, by
obtaining the last such report. Through discussion or evidence of
sign-off confirm that management has received and reviewed these
reports.
