INSURANCE INTERNAL AUDIT CHECKLIST

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--- POLICY COMPLIANCE & DOCUMENTATION ---
[ ] Policy Effective Date
[ ] Policy Expiration Date
[ ] Policy Number
[ ] Policy Form Type (Standard Form, Customized Form, Endorsement Form)
[ ] Summary of Coverage Terms
[ ] Copy of Policy Document
[ ] Regulatory Compliance Status (Compliant, Non-Compliant, Pending Review)
[ ] Jurisdiction/State

--- CLAIMS MANAGEMENT PROCESS ---
[ ] Date of Loss Reported
[ ] Claim Number
[ ] Claim Type (Property Damage, Bodily Injury, Liability, Other)
[ ] Description of Loss
[ ] Estimated Loss Amount
[ ] Claim Status (Open, Investigation, Settled, Denied)
[ ] Date of First Payment
[ ] Claims Adjuster Signature

--- UNDERWRITING PRACTICES ---
[ ] Average Loss Ratio (Last 3 Years)
[ ] Underwriting Guideline Adherence (Fully Compliant, Partially Compliant, Not Compliant)
[ ] Last Underwriting Guideline Review Date
[ ] Summary of Recent Underwriting Risks Identified
[ ] Types of Risks Currently Underwritten (Property, Liability, Workers Compensation, Commercial Auto, Professional Liability)
[ ] Average Policy Premium

--- REINSURANCE PROGRAM ---
[ ] Total Reinsurance Recoverable (USD)
[ ] Reinsurance Type (e.g., Proportional, Excess of Loss) (Proportional, Excess of Loss, Quota Share, Unilateral Cash Collateral)
[ ] Last Reinsurance Treaty Renewal Date
[ ] Summary of Key Reinsurance Treaty Terms
[ ] Reinsurance Treaty Document(s)
[ ] Primary Reinsurer Credit Rating (AAA, AA, A, BBB, BB, Below Investment Grade)
[ ] Percentage of Risk Reinsured

--- FINANCIAL REPORTING & CONTROLS ---
[ ] Total Premium Revenue (Year-to-Date)
[ ] Net Income/Loss (Year-to-Date)
[ ] Date of Last Financial Statement Review
[ ] Audit Opinion Type (Unqualified, Qualified, Adverse, Disclaimer)
[ ] Summary of Significant Accounting Policies
[ ] Supporting Financial Documentation (e.g., Trial Balance)
[ ] Reserve Adequacy Ratio

--- REGULATORY COMPLIANCE ---
[ ] Last Regulatory Exam Date
[ ] Primary Regulatory Body (State Insurance Department, Federal Government Agency, Other)
[ ] Summary of Findings from Last Exam
[ ] Number of Open Regulatory Issues
[ ] Applicable Regulations (Select all that apply) (NAIC Model Laws, GLBA, HIPAA, State-Specific Regulations)
[ ] Copy of Exam Report
[ ] Date of Next Scheduled Exam

--- DATA SECURITY & PRIVACY ---
[ ] Compliance Framework Adherence (e.g., GDPR, CCPA) (GDPR, CCPA, Other (Specify in Long Text))
[ ] Specify 'Other' Compliance Framework (if selected above)
[ ] Number of Data Breach Incidents in Last Year
[ ] Last Data Security Risk Assessment Date
[ ] Data Encryption Methods Implemented (At Rest, In Transit, None)
[ ] Data Access Controls (Role-Based Access, Least Privilege, Other (Specify))
[ ] Specify 'Other' Data Access Controls (if selected above)

--- BUSINESS CONTINUITY & DISASTER RECOVERY ---
[ ] Last BC/DR Plan Review Date
[ ] Summary of Key Changes Since Last Review
[ ] BC/DR Plan Testing Frequency (Annually, Bi-Annually, Quarterly, As Needed)
[ ] Date of Last BC/DR Test
[ ] Summary of Test Results & Findings
[ ] Critical Systems Tested (Core Insurance System, Claims Processing System, Customer Relationship Management (CRM), Financial Systems, Email Servers, Data Backup and Recovery Systems)
[ ] Recovery Time Objective (RTO) - Hours
[ ] Recovery Point Objective (RPO) - Hours
[ ] BC/DR Plan Document

--- CUSTOMER RELATIONSHIP MANAGEMENT ---
[ ] Number of Customer Complaints Received
[ ] Complaint Resolution Time Adherence (Within SLA, Slightly Outside SLA, Significantly Outside SLA)
[ ] Summary of Recent Customer Feedback Trends
[ ] Channels Used for Customer Communication (Email, Phone, Chat, Mail)
[ ] Date of Last Customer Satisfaction Survey
[ ] Agent Training on Customer Service Best Practices (Completed, In Progress, Not Started)

--- INTERNAL CONTROLS EFFECTIVENESS ---
[ ] Overall Internal Control Rating (Satisfactory, Needs Improvement, Unsatisfactory)
[ ] Number of Control Deficiencies Identified
[ ] Summary of Key Control Deficiencies
[ ] Management Response to Control Deficiencies (Adequate, Needs Improvement, Not Provided)
[ ] Date of Last Control Self-Assessment
[ ] Reviewer Signature

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