《寿险公司运作》课程教学大纲（英文）
《Insurance Company Operations》
Course Teaching Outline
Number： 53220236
Basic Information：
1．Credit hour：2
Name： Insurance Company Operations
Lesson hour：34
2．Nature：Elective Course
3．Applicability：Economics（Insurance）
Target Student：Bachelor
4．Courses studied before：Insurance, Life Insurance, Insurance English
5 ． Preferred Teaching Material ： Miriam A. Orsina, Gene. Stone 《 Insurance Company
Operations》, LOMA INC 2005
Alternative Teaching Material：Kenneth Black,《Life Insurance》, Peking University
Press, 1999
6．Examination：Open-book Examination
7．Teaching Surrounding：Video classroom with projection
1、Objective and Requirements
《Insurance Company Operations》is a elective course for the major of Insurance.
After learning the course, the students should be able to know the background
information on Insurance market, the organization and administration modes and the
business process of Life Insurer in USA and Canada, at the same time to master
profession English better with the English teaching material and to meet the demand
of training talent with international knowledge and eyesight. The Students should be
able to know the role of life insurer in financial industry, its organizational
structure, to know the Marketing, Product and the strategies of Life insurer, to master
the main business process such as Underwriting, Alteration and Claim for life insurance
and annuity business.
2、Contents and Lesson Hour Distribution
Contents and Lesson Hour Distribution
Chapter
Contents
Chapter
Life Insurance Company
1:
Operations
Chapter
2:
Lesson
Hour
Teach
2
2
2
2
Competition, Regulation,
and Ethics in the Life
Insurance Industry
Experiment
Chapter
3:
Life Insurance Company
Formation and
4
4
4
4
4
4
Product Development
4
4
Pricing Insurance Products
2
2
Product Distribution
2
2
2
2
2
2
4
4
2
2
34
34
Restructuring
Chapter
4:
The Organizational
Structure of Insurance
Companies
Chapter
Marketing Activities and
5:
Strategies
Chapter
6:
Chapter
7:
Chapter
8:
Chapter
Home Office Support for
9:
Distribution Systems
Chapter
Life Insurance
10:
Underwriting
Chapter
11:
Customer Service
Chapter
Claim and Annuity Benefit
12:
Administration
Total
3、Contents of Teaching Plan
Chapter 1: Life Insurance Company Operations
【Objectives】
1. the types of financial institutions that comprise the financial services industry
2. the roles that life insurance companies play in the financial services industry
3. strategic planning for life insurance companies
【Emphases】the roles that life insurance companies play in the financial services
industry
【Difficulties】the concepts of risk and risk management
【Ways and Methods】Teaching in the Classroom
【Contents】
1. The Roles of Life Insurance Companies
1)
Provider of Financial Industry
2)
Financial Intermediaries
2.

Life Insurance Company Operations
Integration Among Functional Areas
3. Risk Management in Life Insurance Companies
4. Strategic Planning for Operations
1)
Strategic Alliances
2)
Outsourcing
【Questions for Review and Thinking】
1. key words：life insurance, annuity, risk, liquidity risk, outsourcing
2. Describe the different types of financial institutions that comprise the financial
services industry
3. Describe the roles that life insurance companies play in the financial services
industry
4. List the essential operations that all life insurance companies undertake
5. Explain the concepts of risk and risk management
6. Explain the purpose of strategic planning for life insurance companies
Chapter 2: Competition, Regulation and Ethics in the Life
Insurance Industry
【Objectives】
1. the Competition between Life Insurance Company and Other Financial
Institutions
2. the life insurance regulatory system in the United States
3. the three general areas of solvency regulation
4. the importance of ethics in the life insurance industry
【Emphases】the life insurance regulatory system in the United States
【Difficulties】the three general areas of solvency regulation
【Ways and Methods】Teaching in the Classroom
【Contents】
1. Competition in the Life Insurance Industry
1) Recent Reforms in USA Financial Service Industry
2) Sources of Competition for Insurance Product Sales
2. Regulation of the Life Insurance Industry
3. Ethics for Life Insurance Companies
【Questions for Review and Thinking】
1. key words：holding company, solvency, functional regulation, policy reserve
2. Describe the impact of the Gramm-Leach-Bliley Act on the operations of U.S. A life
insurance companies
3. Discuss the importance of ethics in the life insurance industry
4. Explain how insurers can improve the ethical decision making and professionalism
of their employees and insurance producers
Chapter 3: Life Insurance Company Formation and Restructuring
【Objectives】
1. the corporate Structure of Life Insurance Companies
2. stock insurance company and mutual insurance company
3. the demutualization of mutual insurance company
【Emphases】the corporate Structure of Life Insurance Companies
【Difficulties】stock insurance company and mutual insurance company
【Ways and Methods】Teaching in the Classroom
【Contents】
1. The corporate structure of life insurance companies
2. Requirements for incorporation

Incorporating in the United States
3. Insurance company licensing

Licensing of Life Insurance Companies in the United States
4. Stock and mutual life insurance companies
1) Proportion of Stock Companies to Mutual Companies
2) Participating and Nonparticipating Life Insurance Policies
5. Changing the corporate structure
1) Mergers and Acquisitions
2) Holding Company Systems
3) Demutualization
4) Mutual Holding Company Conversion
【Questions for Review and Thinking】
5)
Key words：stock insurance company，mutual insurance company ， policy dividend，
merge，acquisition， demutualization
6)
Discuss the procedures for incorporating and licensing a life insurance company
7)
Describe the steps involved in the process of demutualization
8)
List the benefits and challenges of mergers and acquisitions
Chapter 4: The Organizational Structure of Insurance Companies
【Objectives】
1. the basic activities in each functional area of a typical life insurance company
2. insurance companies that are organized by function, product, territory, and profit
center
3. the role that committees play in a company’s operations
【Emphases】the basic activities in each functional area of a typical life insurance
company
【Difficulties】insurance companies that are organized by function, product, territory,
and profit center
【Ways and Methods】Teaching in the Classroom
【Contents】
1. Functional areas in a Life Insurance Company
1) Marketing
2) Actuarial
3)
4)
5)
6)
Underwriting
Customer Service
Claim Administration
Annuity Administration
7)
8)
9)
10)
Investments
Accounting
Information Technology
Legal Operations
11) Compliance
12) Human Resources
13) Other Common Functional Areas
2. Components of the Organizational Structure
1)
2)
3)
4)
The Organizational Chart
Pyramidal Structure and Level of Authority
Centralized and Decentralized Organizations
Line Units and Staff Units
3. Traditional Ways Insurers Organize Work Activities
1)
2)
3)
4)
Organization
Organization
Organization
Organization
by
by
by
by
Function
Product
Territory
Profit Center or Strategic Business Unit
4. Alternative Organizational Shapes Committees
5. Committees
【Questions for Review and Thinking】
1．Key words： actuary，centralized organization， decentralized organization ，line
unit，staff unit ，hourglass organization，cluster organization， network organization
2 ． Compare the duties and responsibilities of a company board of
directors ,officers ,managers ,and supervisors
3．Discuss alternative configurations to the traditional organizational pyramid
Chapter 5: Marketing Activities and Strategies
【Objectives】
1. the basic marketing activities of a life insurance company
2. the way to make market identification and matching products to target markets
3. the main sources of marketing information
4. making marketing strategies for company growth
【Emphases】the basic marketing activities of a life insurance company，the way to make
market identification and matching products to target markets
【Difficulties】the way to make market identification and matching products to target
markets
【Ways and Methods】Teaching in the Classroom
【Contents】
1. The Marketing Mix
2. Positioning
3. Market Identification
1) Market Segmentation
2) Target Marketing
4. Matching Products to Target Markets
5. Marketing Information
1) Internal Marketing Environment
2) External Marketing Environment
6. The Marketing Plan
1)
2)
3)
4)
Developing the Marketing Plan
Elements of the Marketing Plan
Communicating the Marketing Plan
Control and the Marketing Plan
7. Marketing Strategies for Company Growth

International Expansion
【Questions for Review and Thinking】
1. Keys words：marketing mix, promotion, distribution, positioning, market segment,
undifferentiated marketing, concentrated marketing, marketing plan
2. Explain the terms market segmentation and target marketing
3. Explain why many insurers have decided to expand their operations internationally
4. Describe the three main sources of marketing information
Chapter 6: Product Development
【Objectives】
1. the product development process
2. the organization of a product development teams
【Emphases】the product development process
【Difficulties】the product development process
【Ways and Methods】Teaching in the Classroom
【Contents】
1. Personnel Involved in Product Development

Product Development Team
2. The Product Development Process
1) Product Planning
2) Comprehensive Business Analysis
3) Technical Design
4) Product Implementation
5) Sales Monitoring and Process Review
3. The Importance of Effective Product Development
【Questions for Review and Thinking】
1. Key words：idea screening, market analysis, test marketing, policy filing
2. list the five main steps in the product development process
3. Discuss how and why insurers monitor early sales of a new product
Chapter 7: Pricing Insurance Products
【Objectives】
1. the pricing strategies used by insurers
2. the function and behavior of mortality rates in pricing for life insurance and life
annuity products
3. Understanding the function of asset-share models
【Emphases】the pricing strategies used by insurers
【 Difficulties 】 the function and behavior of mortality rates in pricing for life
insurance and life annuity products
【Ways and Methods】Teaching in the Classroom
【Contents】
1. Setting Pricing Objectives and Strategies
2. Making Assumptions for Pricing
1) Investment Earnings and Interest Rates
2) Cost of Benefits and the Mortality Factors
3. Bundled and Unbundled Pricing
1) Bundled Pricing for Life Insurance
2) Bundled Pricing for Annuities
4. Policy Reserves and Cash Values
5. Profit-testing Actuarial Assumptions
6. Managing Pricing Results
1) Favorable Deviations
2) Adverse Deviations
【Questions for Review and Thinking】
1. Key words： premium rate, pricing, loading, mortality, acquisition expense
2. Describe the characteristics of mortality data and different types of mortality
tables
3. Explain the difference between gross premiums and net premiums for life insurance
4. Interpret data from a mortality table and calculate the number living from one age
to the next
Chapter 8: Product Distribution
【Objectives】
1. the arrangement of the sales process for insurance products
2. the optional channels to sale insurance products
3. the importance of the sale channel design
【Emphases】the arrangement of the sales process for insurance products
【Difficulties】the optional channels to sale insurance products
【Ways and Methods】Teaching in the Classroom
【Contents】
1. Distribution Systems
2. Personal Selling Distribution Systems
1) The Sales Process
2) Agency-Building Distribution Systems
3) Nonagency-Building Distribution Systems
3. Financial Institutions Distribution Systems
4) Brokers/Dealers
5) Banks
6) Insurance Companies
4. Direct Response Distribution Systems

Direct Response Distribution Activities
5. Distribution Channel Decisions
7) Characteristics of Customer in Target Markets
8) Characteristics of Products the Company Sell
9) Cost Associated with Each System
10) Degree of Control the Insurer Intends to
11) Exercise over Distribution
12) Characteristics of the Insurer
13) Insurer’s External Marketing Environment
【Questions for Review and Thinking】
1. Key words： MLA, broker, persistency, agency system, TPM
2. Explain how variable products are distributed in the United States
3. Describe the primary types of media used in direct response distribution systems
4. Discuss some of the important factors that insurance companies consider when
determining which product distribution system or systems to use
Chapter 9: Home Office support for Distribution Systems
【Objectives】
1. Master how the home office supports the agency-building distribution systems
2. describe the types of sales support and technology support that insurers may provide
to the agency-building distribution systems
3. describe the activities that insurers conduct to monitor the market conduct of their
producers
【Emphases】the types of sales support and technology support that insurers may provide
to the agency-building distribution systems
【Difficulties】the types of sales support and technology support that insurers may
provide to the agency-building distribution systems
【Ways and Methods】Teaching in the Classroom
【Contents】
1. Support for Agency-Building Distribution Systems
1)
2)
3)
4)
5)
Recruiting and Contracting
Licensing and Training
Compensation
Sales Support
Technology Support
2. Support for Nonagency-Building Distribution Systems
3. Support for Financial Institutions Distribution Systems
1) Brokers/Dealers
2) Banks
【Questions for Review and Thinking】
1. Key words： heaped commission, level commission, financial planning, service fee,
sales manager
2. Explain how the home office supports agency-building distribution systems in
recruiting, training, licensing, and compensating producers
3. Discuss the similarities and differences between the home office’s support for
agency-building distribution systems and for nonagency-building distribution systems
Chapter 10: Life Insurance Underwriting
【Objectives】
1. understand the importance of sound underwriting
2. know about the underwriting process
3. know about the fundamentals of life insurance underwriting
【Emphases】the underwriting process，the fundamentals of life insurance underwriting
【Difficulties】the fundamentals of life insurance underwriting
【Ways and Methods】Teaching in the Classroom
【Contents】
1. The Importance of Sound Underwriting

Antiselection and Persistency
2. Organization of Underwriting
3. Underwriting Philosophy and Underwriting Guidelines
4. Fundamentals of Individual Life Insurance Underwriting

Risk Assessment Factors
5. Fundamentals of Group Life Insurance Underwriting
6. Regulatory Requirements and Underwriting
1) Unfair Discrimination
2) Consumer Privacy
7. The Underwriting Process
1) Field Underwriting
2) Review the Application for Insurance
3) Gathering Additional Information
8. Reinsuring Excess Risk
1) Basic Concepts of Reinsurance
2) Retention Limits
【Questions for Review and Thinking】
1. key words: underwriting, antiselection, preferred class, standard
substandard class, moral hazard, insurable interest, reinsurance treaty
class,
2. Identify the key participants in life insurance underwriting and explain the role
of each type of participant
3. List the four general risk classes to which life insurance underwriters assign
proposed insured
4. Explain how group life insurance underwriting differs from individual life insurance
underwriting
5. Describe the numerical rating system and explain how life underwriters use it to
classify risks
Chapter 11: Customer Service
【Objectives】
1. understand the importance of customer services
2. know about the customer service transactions
3. know about the way to evaluating customer service
【Emphases】the customer service transactions
【Difficulties】the way to evaluating customer service
【Ways and Methods】Teaching in the Classroom
【Contents】
1. Insurance Company Customers
1) External Customers
2) Internal Customers
3) Insurance Producers
2. Who Provides Customer Service
3. Why is Customer Service So Important？
4. Effective Customer Service

The Changing Role of Customer Service Representatives
5. Customer Service Transactions for Individual Life Insurance and
Annuities
1) Policyowner Information Changes
2) Changes in Ownership of the Policy
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
Annuitant and Annuity Date Changes
Beneficiary Changes
Premium Payment Changes
Insurance Producer Changes
Life Insurance Coverage Changes
Fund Allocations for Variable Products
Determining Life Insurance Cash Values, Policy Loans, and Policy Dividends
Cash Surrender and Withdrawals
Life Insurance Policy Reinstatements
Policy Replacement
6. Customer Service Transactions for Group life Insurance and Annuities
7. Evaluating Customer Service
1) Evaluating the timeliness of Customer Service
2) Evaluating the Quality of Customer Service
8. Customer Relationship Management
9. Technology and Customer Service Delivery
【Questions for Review and Thinking】
1. Key words ： customer service, endorsement, annuitant, policy rider, net cash
surrender value, CRM
2. Define the term customer contact center
3. List and describe some typical customer service transactions for individual life
insurance and annuities
4. Identify the various customers of an insurance company
Chapter 12: Claim and Annuity Benefit Administration
【Objectives】
1. grasp the life insurance claim decision process
2. know about claims on reinsured policies
【Emphases】the life insurance claim decision process
【Difficulties】claims on reinsured policies
【Ways and Methods】Teaching in the Classroom
【Contents】
1. The life insurance claim administration function
1) Claim Philosophy
2) Claim Staff
3) Regulation of Claim Administration
2. The life insurance claim decision process
1)
2)
3)
4)
5)
6)
Verification of Policy Status
Verification of Coverage of the Insurer
Verification of the Loss
Verification of Policy Coverage of the Loss
Handling Contestable Claims
Making a Claim Decision
3. Life insurance claim investigation
1) Claim Fraud
2) Confidentiality
4. Claims on reinsured policies
1) Notification of Claims
2) Claim Decisions
5. Administration of annuity policy benefits
1) Annuity Death Benefit Administration
2) Annuity Payout Administration
【Questions for Review and Thinking】
1. Key words：claim analyst， suicide exclusion ， contestable period
2. List and describe the basic activities in the life insurance claim decision process
3. Define material misrepresentation and explain how an insurer handles a material
misrepresentation
4. Discuss the actions that a claim analyst takes when approving and denying life
insurance claims
References
1.
2.
3.
4.
5.
赵猛 编著,《人寿保险—个人理财新工具》, 中国金融出版社, 2006 年 12 月
陈文辉 主编,《团体保险发展研究》, 中央编译出版社, 2005 年 1 月
许谨良 编著,《人身保险原理和实务》, 上海财经大学出版社, 02 年 7 月
魏巧琴,《最新人身保险学》同济大学出版社, 2005 年 8 月
Kenneth Black,《Life Insurance》, 北京大学出版社, 1999 年