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Regulation for Insurance Brokers
1. Short
title and commencement
2. Definitions
3.
Functions of a direct broker
4.
Functions of a re-insurance broker
5.
Functions of composite broker
6.
Application for grant of licence
7.
Application
to conform to the requirements
8.
Furnishing of information, clarification and personal representation
9.
Consideration of application
10.
Requirements of capital
11. Procedure
for licensing
12. Validity of
licence
13. Renewal of
licence
14.
Procedure
where a licence is not granted
15.
Effect of refusal to grant licence
16. Issue
of a duplicate licence
17.
Action against a person acting as an insurance broker without a
valid licence
18.
Payment of fees and the consequences of failure to pay fees
19. Remuneration
20.
Ceiling on
business from single client
21. Code of conduct
22. Deposit
requirements
23.
Segregation of insurance money
24.
Professional indemnity insurance
25.
Maintenance of books of account, records, etc.
26.
Submission of half-yearly results
27.
Internal control and systems
28.
Disclosures to the Authority
29.
Authority's right to inspect
30. Notice
before inspection
31.
Submission of
report to the Authority
32.
Communication of findings, etc.
33.
Appointment of investigator
34.
Cancellation or suspension of licence with notice
35.
Cancellation or suspension of licence without notice
36.
Manner of making order of cancellation/suspension with notice
37.
Manner of holding enquiry before suspension or cancellation
38.
Show-cause notice and order
39.
Publication of order of suspension or cancellation
40.
Effect of cancellation or suspension of licence
41. General
Schedule I
Schedule II
In
exercise of the powers conferred by section 114A of the Insurance
Act, 1938 (4 of 1938) read with sections 14 and 26 of the Insurance
Regulatory and Development Authority Act, 1999 (41 of 1999), the
Authority in consultation with the Insurance Advisory Committee,
hereby makes the following regulations, namely:
1.
Short title and commencement
(1)
These regulations may be called the Insurance Regulatory and
Development Authority (Insurance Brokers) Regulations, 2002.
(2)
They shall come into force on the date of their publication in the
Official Gazette.
2.
Definitions
(1)
Unless the context otherwise requires,
(a)
"Act" means the Insurance Act, 1938 (4 of 1938);
(b)
"Advisory Committee" means the Advisory Committee
constituted under section 25 of the Insurance Regulatory and
Development Authority Act, 1999 (41 of 1999);
(c)
"Authority" means the Insurance Regulatory and Development
Authority established under sub-section (1) of section 3 of
Insurance Regulatory and Development Authority Act, 1999 (41 of
1999);
(d)
"composite broker" means an insurance broker who for the
time being licensed by the Authority to act as such, for
a
remuneration, arranges insurance for his clients with insurance
companies and/or re-insurance for his client/s;
(e)
"direct broker" means an insurance broker who for the time
being licensed by the Authority to act as such, for a remuneration
carries out the functions as specified under regulation 3 either in
the field of life insurance or general insurance or both on behalf
of his clients;
(f)
"enquiry officer" means an officer of the
Authority, or any other person having experience in insurance
business, who is appointed by the Authority under regulation 37, to
hold an enquiry against an insurance broker;
(g)
"form" means the forms specified under these regulations;
(h)
"inspecting authority" means one or more of its
officers appointed by the Authority to discharge the functions
stated in regulation 29;
(i)
"insurance broker" means a person for the time
being licensed by the Authority under regulation 11, who for a
remuneration arranges insurance contracts with insurance companies
and/or re-insurance companies on behalf of his clients.
Explanation
: The term
"insurance broker" wherever it appears in these
regulations shall be deemed to mean a direct broker, a re-insurance
broker or a composite broker, as the case may be, unless expressly
stated to the contrary;
(j)
"person" means--
(i)
an individual; or
(ii)
a firm; or
(iii)
a company formed under the Companies Act, 1956 (1 of 1956); or
(iv)
a co-operative society registered under the Co-operative Societies
Act, 1912 or under any law for the registration of co-operative
societies; or
(v)
any other person recognized by the Authority to act as an insurance
broker;
(k)
"principal officer" means--
(i)
proprietor, in the case of a proprietary concern; or
(ii)
a partner, in the case of a partnership firm; or
(iii)
a director, who is responsible for the activities of the insurance
broking in the case of body corporate; or
(iv)
the chief executive officer appointed exclusively to carry out the
functions of an insurance broker;
(l)
"regulations" means Insurance Regulatory and
Development Authority (Insurance Brokers) Regulations, 2002;
(m) "reinsurance broker" means an insurance broker who,
for a remuneration, arranges re-insurance for direct insurers
with
insurance and re-insurance companies.
(2)
Words and expressions used and not defined in these regulations but
defined in the Insurance Act, 1938 (4 of 1938), or the Life
Insurance Corporation Act, 1956 (31 of 1956), or the General
Insurance Business (Nationalisation) Act, 1972 (57 of 1972), or
Insurance Regulatory and Development Authority Act, 1999 (41 of
1999) shall have the meaning respectively assigned to them in those
Acts or the rules and regulations made thereunder, as the case may
be.
3.
Functions of a direct broker
The
functions of a direct broker shall include any one or more of the
following:
(a)
obtaining detailed information of the client's business and risk
management philosophy;
(b)
familiarising himself with the client's business and underwriting
information so that this can be explained to an insurer and others;
(c)
rendering advice on appropriate insurance cover and terms;
(d)
maintaining detailed knowledge of available insurance markets, as
may be applicable;
(e)
submitting quotation received from insurer/s for consideration of a
client;
(f)
providing requisite underwriting information as required by
an insurer in assessing the risk to decide pricing terms and
conditions for cover;
(g)
acting promptly on instructions from a client and providing him
written acknowledgements and progress reports;
(h)
assisting clients in paying premium under section 64VB of Insurance
Act, 1938 (4 of 1938);
(i)
providing services related to insurance consultancy and risk
management;
(j)
assisting in the negotiation of the claims; and
(k)
maintaining proper records of claims.
4.
Functions of a re-insurance broker
The
functions of a re-insurance broker shall include any one or more of
the following:
(a)
familiarising himself with the client's business and risk retention
philosophy;
(b)
maintaining clear records of the insurer's business to assist the
re-insurer(s) or others;
(c)
rendering advice based on technical data on the re-insurance covers
available in the international insurance and the re-insurance
markets;
(d)
maintaining a database of available re-insurance markets, including
solvency ratings of individual re-insurers;
(e)
rendering consultancy and risk management services for re-insurnace;
(f)
selecting and recommending a re-insurer or a group of
re-insurers;
(g)
negotiating with a re-insurer on the client's behalf;
(h)
assisting in case of commutation of re-insurance contracts placed
with them;
(i)
acting promptly on instructions from a client and providing
it written acknowledgements and progress reports;
(j)
collecting and remitting premiums and claims within such time
as agreed upon;
(k)
assisting in the negotiation and settlement of claims;
(l)
maintaining proper records of claims; and
(m) exercising due care and diligence at the time of selection of
re-insurers and international insurance brokers having regard to
their respective security rating and establishing respective
responsibilities at the time of engaging their services.
5.
Functions of composite broker
A
composite broker shall carry out any one or more of the functions
mentioned in regulations 3 and 4.
6.
Application for grant of licence
(1)
An application by a person for grant of a licence as an insurance
broker shall be made in
Form A to the Authority.
(2)
The application under sub-regulation (1) shall be made for any one
or more of the following categories, namely--
(a) direct broker;
(b) re-insurance broker;
(c) composite broker,
alongwith
the requisite fees as specified in regulation 18.
7.
Application to conform to the requirements
An
application, not complete in all respects and not conforming to the
instructions specified in
Form A and these regulations, shall be
rejected:
PROVIDED
that, before rejecting any such application, the applicant shall be
given a reasonable opportunity to complete the application in all
respects and rectify the errors, if any.
8.
Furnishing of information, clarification and personal representation
(1)
The authority may require an applicant to furnish any further
information or clarification for the purpose of disposal of the
application, and, thereafter, in regard to any other matter as may
be deemed necessary by the Authority.
(2)
The applicant or its principal officer shall, if so required, appear
before the Authority for a personal representation in connection
with an application.
9.
Consideration of application
(1)
The Authority while considering an application for grant of a
licence shall take into account, all matters relevant to the
carrying out of the functions by the insurance broker.
(2)
Without prejudice to the above, the Authority in particular, shall
take into account the following, namely--
(A)
whether the applicant is not suffering from any of the
disqualifications specified under sub-section (5) of section 42D of
the Act;
(B)
whether the applicant has the necessary infrastructure, such as,
adequate office space, equipment and trained manpower to effectively
discharge his activities;
(C)
whether the applicant has in his employment a minimum of two persons
who have the necessary qualifications specified in clause (F) below
and experience to conduct the business of insurance broker;
(D)
whether any person, directly or indirectly connected with the
applicant, has been refused in the past the grant of a licence by
the Authority.
Explanation
: For the purposes of
this sub-clause, the expression "directly or indirectly
connected" means a relative in the case of an individual, and
in the case of a firm or a company or a body corporate, an
associate, a subsidiary, an inter-connected undertaking or a group
company of the applicant. It
is hereby clarified that these terms shall have the same meanings as
ascribed to them in the Companies Act, 1956 (1 of 1956), or MRTP
Act, 1969 (54 of 1969) as the case may be;
(E)
whether the applicant fulfils the capital requirements as specified
in regulation 10 and deposit requirements as specified in regulation
22;
(F)
whether the principal officer of the applicant--
(i)
possesses the minimum qualification of:
(a)
Bachelor's/Master's degree in arts, science, or social sciences or
commerce or its equivalent from any institution/university
recognized by any State Government or the Central Government; or
(b)
Bachelor's degree in engineering or its equivalent from any
institution/university recognized by any State Government or the
Central Government; or
(c)
Bachelor's degree in law or its equivalent from any
institution/university recognized by any State Government or the
Central Government; or
(d)
Master's degree in Business Administration or its equivalent from
any institution/university recognized by any State Government or the
Central Government; or
(e)
Associate/Fellow of the Insurance Institute of India, Mumbai; or
(f)
Associate/Fellow of the Institute of Risk Management, Mumbai; or
(g)
Any post-graduate qualification of the Institute of Insurance and
Risk Management, Hyderabad; or
(h)
Associate/Fellow of the Institute of Chartered Accountants of India,
New Delhi; or
(i)
Associate/Fellow of the Institute of Costs and Works Accountants of
India, Kolkata; or
(j)
Associate/Fellow of the Institute of Company Secretaries of India,
New Delhi; or
(k)
Associate/Fellow of the Actuarial Society of India; or
(l)
Certified Associateship of the Indian Institute of Bankers, Mumbai;
or
(m)
any other qualification specified from time to time by the Authority
under these regulations; and
(ii)
the principal officer of the applicant has received at least
one hundred hours of theoretical and practical training from an
institution recognised by the Authority from time to time:
PROVIDED
that where the principal officer of the applicant,--
(a)
has been carrying on re-insurance related activity or
insurance consultancy for a continuous period of seven years,
preceding the year in which such an application is made; or
(b)
has for a period of, not less than seven years prior to the
application made to the Authority has been a principal under-writer
or has held the position of a manager in any one of the nationalised
insurance companies in India; or
(c)
is an Associate/Fellow of the Insurance Institute of India,
Mumbai, or Associate/Fellow of the Institute of Risk Management,
Mumbai, or Associate/Fellow of the Actuarial Society of India, or
any post-graduate qualification of the Institute of Insurance and
Risk Management, Hyderabad,
the
theoretical and practical training from an institution recognised by
the Authority from time to time according to a syllabus approved by
the Authority shall be fifty hours.
(iii)
has passed an examination, at the end of the period of training
mentioned in the proviso above, conducted by the National Insurance
Academy, Pune or any other examining body recognised by the
Authority;
(G)
whether the principal officer has not violated the code of conduct
as specified in Schedule III to these regulations;
(H)
that the applicant is not engaged in any other business other than
the main objects of the applicant; and
(I)
the authority is of the opinion that the grant of licence
will be in the interest of policyholders.
Exception
: In the case of
applications made to the Authority immediately following the
notification of these regulations, the requirements under
sub-regulation (2)(C) shall stand modified to the extent that
instead of two qualified persons mentioned in the requirement be
scaled down to one person, who should have qualified himself at the
latest by the time of the grant of a licence under these
regulations. This
Exception may be available only to applications made to the
Authority upto 31st March, 2003.
(3)
Any employee responsible for soliciting and procuring insurance
business on behalf of an insurance broker shall also have to fulfil
the requirements mentioned in sub-regulations (1) and (2) above and
a list of such employees need to be provided to the Authority and
acknowledged by it.
10.
Requirements of capital
(1)
Any applicant seeking to become an insurance broker under these
regulations should satisfy the following conditions:
(i)
it shall have a minimum amount of capital as mentioned below:
Category
Minimum amount (Rupees)
(a)
Direct broker
Fifty lakhs
(b)
Re-insurance broker
Two hundred lakhs
(c)
Composite broker
Two hundred and fifty lakhs;
(ii)
the capital in the case of a company limited by shares and a
co-operative society shall be in the form of equity shares;
(iii)
the capital in the case of other applicants shall be brought
in cash;
(iv)
the applicant shall exclusively carry on the business of an
insurance broker as licensed under these regulations.
(2)
No part of the capital of an applicant shall be held by a non-Indian
interest beyond 26 per cent at any time.
For the purposes of these regulations, the calculations of
non-Indian interest shall be made in the same manner as specified in
Insurance Regulatory and Development Authority (Registration of
Indian Insurance Companies) Regulations, 2000 for an insurer.
11.
Procedure for licensing
The
Authority on being satisfied that the applicant fulfils all the
conditions specified for the grant of licence, shall grant a licence
in Form B and send an intimation thereof to the applicant mentioning
the category for which the Authority has granted the licence.
The licence shall be issued subject to the insurance broker
adhering to the conditions and the code of conduct as specified by
the Authority from time to time.
12.
Validity of licence
A
licence once issued shall be valid for a period of three years from
the date of its issue, unless the same is suspended or cancelled
pursuant to these regulations.
13.
Renewal of licence
(1)
An insurance broker may, within thirty days before the expiry of the
licence, make an application in
Form A to the Authority for renewal
of licence:
PROVIDED
however that if the application reaches the Authority later than
that period but before the actual expiry of the current licence, an
additional fee of Rupees one hundred only shall be payable by the
applicant to the Authority:
PROVIDED
FURTHER that the Authority may for sufficient reasons offered in
writing by the applicant for a delay not covered by the previous
proviso, accept an application for renewal after the date of the
expiry of the licence on a payment of an additional fee of seven
hundred and fifty rupees only by the applicant.
(2)
An insurance broker before seeking a renewal of licence, shall have
completed, at least twenty-five hours of theoretical and practical
training, imparted by an institution recognized by the Authority
from time to time.
(3)
The application for a renewal, under sub-regulation (1) shall be
dealt with in the same manner as is specified under regulation 9.
(4)
The Authority, on being satisfied that the applicant fulfils all the
conditions specified for a renewal of the licence, shall renew the
licence in Form B for a period of three years and send an intimation
to that effect to the applicant.
(5)
An insurance broker licensed under these regulations for a specified
category may also apply for the grant of a licence by the Authority
for any other category by fulfilling the requirements of these
regulations. However,
such application shall be made only after a lapse of one year from
the grant of a licence in the first instance.
14.
Procedure where a licence is not granted
(1)
Where an application for grant of a licence under regulation 6 or of
a renewal thereof under regulation 13, does not satisfy the
conditions set out in regulation 9, the Authority may refuse to
grant the licence:
PROVIDED
that no application shall be rejected unless the applicant has been
given a reasonable opportunity of being heard.
(2)
The refusal to grant a licence shall be communicated by the
Authority within thirty days of such refusal to the applicant
stating therein the grounds on which the application has been
rejected.
(3)
Any applicant, if aggrieved by the decision of the Authority, may
apply within a period of thirty days from the date of receipt of
such intimation, to the Chairman of the Authority for a
reconsideration of its decision.
(4)
The Chairman of the Authority shall consider such an application and
communicate his decision thereon to the applicant in writing within
six weeks of the receipt thereof.
15.
Effect of refusal to grant licence
Any
applicant, whose application for grant of a licence under regulation
6 or of a renewal thereof under regulation 13 has been refused by
the Authority, shall, on and from the date of the receipt of the
communication under regulation 13(2) cease to act as an insurance
broker. He, however,
shall continue to be liable to provide services in respect of
contracts already entered into through him.
Such a service shall continue only up to the period of expiry
of those current contracts, details of which shall be disclosed to
the Authority on receipt of the communication under regulation 13.
16.
Issue of a duplicate licence
(1)
In the event of a licence being lost or destroyed or mutilated, an
insurance broker shall submit to the Authority an application along
with a fee of Rupees one thousand requesting for the issue of a
duplicate licence and with a declaration giving full details
regarding the issue of the licence and its loss or destruction or
mutilation.
(2)
The Authority, after satisfying itself that the original licence has
been lost, destroyed or mutilated, shall issue a duplicate licence
in Form B with an endorsement thereon that it is a duplicate one.
17.
Action against a person acting as an insurance broker without a
valid licence
(1)
Notwithstanding and without prejudice to initiation of any criminal
proceedings against any person, who acts as an insurance broker
without holding a valid licence issued under these regulations, the
Authority may invoke against such a person penal action under the
Act.
(2)
Where the person falling under sub-regulation (1), is a company or
firm or body corporate, without prejudice to any other proceedings
which may be taken by the Authority against the company or firm or
body corporate, every director, manager, secretary or other officer
of the company or body corporate, and every partner of the firm, who
is knowingly a party to such a contravention shall also be liable to
be proceeded against.
18.
Payment of fees and the consequences of failure to pay fees
(1)
Every applicant eligible for the grant of a licence shall pay such
fees in such a manner and within such a period as specified in
Schedule II.
(2)
Where an insurance broker fails to pay the annual fees payable under
sub-regulation (1), the Authority may suspend the licence, whereupon
the insurance broker shall cease to carry on business for the period
during which the suspension subsists.
19.
Remuneration
(1)
No insurance broker shall be paid or contract to be paid by way of
remuneration (including royalty or licence fees or administration
charges or such other compensation), an amount exceeding:
(A)
On direct general insurance business--
(i)
on tariff products:
(a)
10 per cent of the premium on that part of the business which is
compulsory under any statute or any law in force;
(b)
12-1/2 per cent of the premium on others.
(ii)
on non-tariff products:
17-1/2
per cent of the premium on direct business.
(B) On direct life insurance business--
(i)
individual insurance :
(a)
30 per cent of first year's premium;
(b)
5 per cent of each renewal premium.
(ii)
annuity :
(a)
immediate annuity or a deferred annuity in consideration of a single
premium, or where only one premium is payable on the policy:
2
per cent of premium
(b)
deferred annuity in consideration of more than one premium :
(i)
7-1/2 per cent of first year's premium;
(ii)
2 per cent of each renewal premium.
(iii)
group insurance and pension schemes:
(a)
one year renewable group term insurance, gratuity, superannuation,
group savings linked insurance--
7-1/2
per cent of risk premium.
Note
: Under group
insurance schemes there will be no remuneration for savings
component.
(b)
single premium--
2
per cent of risk premium.
(c)
annual contributions, at new business procurement stage--
5
per cent, of non-risk premium with a ceiling of Rupees three lakhs
per scheme.
(d)
single premium new business procurement stage--
0.5
per cent with a ceiling of Rupees five lakhs per scheme.
(e)
remuneration for subsequent servicing--
(i)
one year renewable group term assurance--
2
per cent of risk premium with a ceiling of Rupees 50,000 per scheme.
(C) On reinsurance business--
(i)
as per market practices prevalent from time to time.
Explanation :
For purposes of the procurement of business, an insurer shall not
pay an agency commission, allow a special discount, and pay a
remuneration to brokers for the same insurance contract.
(2)
The settlement of accounts by insurers in respect of remuneration of
brokers shall be done on a monthly basis and it must be ensured that
there is no cross settlement of outstanding balances.
20.
Ceiling on business from single client
(1)
The business of the insurance broker shall be carried in such a
manner that, not more than 50 per cent of the premium (quantum,
receipts, etc. as the case may be) in the first year of business, 40
per cent of the premium in the second year of business, and 30 per
cent of the premium from the third year of business onwards shall
emanate from any one client.
Note : For the purposes of this regulation, the term "client" shall
include, in the case of a firm or a
company, an associate or a subsidiary or a group concern
under the same management.
(2)
The decision of the Authority as to whether a company, a business or
an organisation is under the same management shall be final.
21.
Code of conduct
Every
insurance broker shall abide by the code of conduct as specified in
Schedule III.
22.
Deposit requirements
(1)
Every insurance broker shall before the commencement of his
business, deposit and keep deposited with any scheduled bank a sum
equivalent to 20 per cent of the initial capital in fixed deposit,
which shall not be released to him unless the prior permission of
the Authority is obtained:
PROVIDED
that the Authority may impose a separate limit of deposit, in any
case not exceeding Rupees one hundred lakhs, for a person covered by
regulation 2(1)(j)(v).
(2)
Every insurance broker shall furnish to the Authority as and when
called upon to do so a statement certified by the bank in which such
fixed deposit is kept.
23.
Segregation of insurance money
(1)
The provisions of section 64VB of the Act shall continue to
determine the question of assumption of risk by an insurer.
(2)
In the case of re-insurance of contracts, it may be agreed between
the parties specifically or as part of international market
practices that the licensed re-insurance broker or composite broker
can collect the premium and remit to the re-insurer and/or collect
the claims due from the re-insurer to be passed on to the insured.
In these circumstances the money collected by the licensed
insurance broker shall be dealt with in the following manner:
(a)
he shall act as the trustee of the insurance money that he is
required to handle in order to discharge his function as a
re-insurance broker and for the purposes of this regulation it shall
be deemed that a payment made to the re-insurance broker shall be
considered as payment made to the reinsurer;
(b)
ensure that "insurance money" is held in an
"Insurance Bank Account" with one or more of the scheduled
banks or with such other institutions as may be approved by the
Authority;
(c)
give written notice to, and receive written confirmation from, a
bank, or other institution that he is not entitled to combine the
account with any other account, or to exercise any right of set-off,
charge or lien against money in that account;
(d)
ensure that all monies received from or on behalf or an insured is
paid into the "Insurance Bank Account" which remains in
the "Insurance Bank Account" to remain in deposit until it
is transferred on to the re-insurer or to the direct insurer;
(e)
ensure that any refund of premium which may become due to a direct
insurer on account of the cancellation of a policy or alteration in
its terms and conditions or otherwise shall be paid by the
re-insurer directly to the direct insurer;
(f)
interest on recovery/payment received shall be for the
benefit of the direct insurer or re-insurer;
(g)
only remove from the "Insurance Bank Account" charges,
fees or commission earned and interest received from any funds
comprising the account;
(h)
take immediate steps to restore the required position if at any time
he becomes aware of any deficiency in the required "segregated
amount".
24.
Professional indemnity insurance
(1)
Every insurance broker shall take out and maintain and continue to
maintain a professional indemnity insurance cover throughout the
validity of the period of the licence granted to him by the
Authority:
PROVIDED
that the Authority shall in suitable cases allow a newly licensed
insurance broker to produce such a guarantee within fifteen months
from the date of issue of the original licence.
(2)
The insurance cover must indemnify an insurance broker against--
(a)
any error or omission or negligence on his part or on the part of
his employees and directors;
(b)
any loss of money or other property for which the broker is legally
liable in consequence of any financial or fraudulent act or
omission;
(c)
any loss of documents and costs and expenses incurred in replacing
or restoring such documents;
(d)
dishonest or fraudulent acts or omissions by brokers' employees or
former employees.
(3)
The indemnity cover--
(a)
shall be on a yearly basis for the entire period of licence;
(b)
shall not contain any terms to the effect that payments of claims
depend upon the insurance broker having first met the liability;
(c)
shall indemnify in respect of all claims made during the period of
the insurance regardless of the time at which the event giving rise
to the claim may have occurred :
PROVIDED
that an indemnity insurance cover not fully conforming to the above
requirements shall be permitted by the Authority in special cases
for reasons to be recorded by it in writing.
(4)
Limit of indemnity for any one claim and in the aggregate for the
year in the case of insurance brokers shall be as follows:
Category
of insurance broker
|
Limit
of indemnity
|
(a)
Direct broker |
three times remuneration
received at the end of every financial year subject to a minimum
limit of Rupees fifty lakhs. |
(b)
Reinsurance broker |
three times remuneration
received at the end of every financial year subject to a minimum
limit of Rupees two crores and fifty lakhs. |
(c)
Composite broker |
three times remuneration
received at the end of every financial year subject to a minimum
limit of Rupees five crores. |
(5)
The uninsured excess in respect of each claim shall not exceed five
per cent of the capital employed by the insurance broker in the
business.
(6)
The insurance policy shall be obtained from any registered insurer
in India who has agreed to--
(a)
provide the insurance broker with an annual certificate containing
the name and address, including the licence number of the insurance
broker, the policy number, the limit of indemnity, the excess, and
the name of the insurer as evidence that the cover meets the
requirements of the Authority;
(b)
send a duplicate certificate to the Authority at the time the
certificate is issued to the insurance broker; and
(c)
inform the insurer immediately of any case of voidance, non-renewal
or cancellation of cover mid-term.
(7)
Every insurance broker shall--
(a)
inform immediately the Authority should any cover be cancelled or
voided or if any policy is not renewed;
(b)
inform immediately the insurer in writing of any claim made by or
against it;
(c)
advise immediately the insurer of all circumstances or occurrences
that may give rise to a claim under the policy; and
(d)
advise the Authority as soon as an insurer has notified that it
intends to decline indemnity in respect of a claim under the policy.
25.
Maintenance of books of account, records, etc.
(1)
Every insurance broker shall prepare for every accounting year--
(i)
a balance-sheet or a statement of affairs as at the end of
each accounting period;
(ii)
a profit and loss account for that period;
(iii)
a statement of cash/fund flow;
(iv)
additional statements on insurance broking business as may be
required by the Authority.
Note
: For purposes of
this regulation, the accounting year shall be a period of 12 months
(or less where a business is started after 1st April) commencing on
the first day of the April of a year and ending on the 31st day of
March of the year following, and the accounts shall be maintained on
accrual basis.
(2)
Every insurance broker shall submit to the Authority, a copy of the
audited financial statements as stated in sub-regulation (1) along
with the auditor's report thereon within ninety days from the close
of the accounting year along with the remarks or observations of the
auditors, if any, on the conduct of the business, state of accounts,
etc., and a suitable explanation on such observations shall be
appended to such accounts filed with the Authority.
(3)
Every insurance broker shall, within ninety days from the date of
the auditor's report take steps to rectify any deficiencies, made
out in the auditor's report and inform the Authority accordingly.
(4)
All the books of account, statements, documents, etc., shall be
maintained at the head office of the insurance broker or such other
branch office as may be designated by him and notified to the
Authority, and shall be available on all working days to such
officers of the Authority, authorised in this behalf by it for an
inspection.
(5)
All the books and documents, statements, contract notes etc.,
referred to in this regulation and maintained by the insurance
broker shall be retained for a period of at least ten years from the
end of the year to which they relate.
26.
Submission of half-yearly results
(1)
Every insurance broker shall before 31st October and 30th April each
year furnish to the Authority a half-yearly unaudited financial
statement containing details of performance, financial position,
etc., along with a declaration confirming the fulfilment of
requirements of capital in accordance with the provisions of
regulation 10 and deposit requirements in accordance with the
provisions of regulation 22.
(2)
Failure to comply with the regulation of sub-regulation (1) will
lead to an action, in accordance with the provisions of regulation
34 being taken against the insurance broker.
27.
Internal control and systems
Every
insurance broker shall ensure that a proper system of internal audit
is practised in business and that his internal controls and systems
are adequate for the size, nature and complexity of his business.
28.
Disclosures to the Authority
(1)
An insurance broker shall disclose to the Authority, as and when
required by it, in any event not later than thirty days of a
requisition, the following information, namely--
(i)
his responsibilities with regard to the placement of an insurance
contract;
(ii)
any change in the information or particulars previously furnished,
which have a bearing on the licence granted to it;
(iii)
the names of the clients whose insurance portfolio he manages or has
managed;
(iv)
any other requirement specified by the Authority from time to time:
PROVIDED
that in the case of a person specified in regulation 2(1)(j)(v), the
Authority may call for and obtain
such information as it deems fit.
29.
Authority's right to inspect
(1)
The Authority may appoint one or more of its officers as an
"inspecting authority" to undertake inspection of the
premises of the insurance broker to ascertain and see how the
business is carried on, and also to inspect the books of accounts,
records and documents of the insurance broker for any of the
purposes specified in sub-regulation (2).
(2)
The purposes referred to in sub-regulation (1) may be as follows,
namely--
(i)
to ensure that the books of account are being maintained in
the manner required;
(ii)
to ensure that the provisions of the Act, rules, regulations
are being complied with;
(iii)
to investigate the complaints received from any insured, any
insurer, other insurance brokers or any other person
on any matter
having a bearing on the activities of the insurance broker; and
(iv)
to investigate the affairs of the insurance broker suo motu in the
interest of proper development of insurance
business or in
policyholders' interest.
30.
Notice before inspection
(1)
Before undertaking an inspection under regulation 29, the Authority
shall give a notice of ten days to an insurance broker for that
purpose.
(2)
Notwithstanding anything contained in sub-regulation (1), where the
Authority is satisfied that in the interests of the policyholders no
such notice shall be given, it may, for reasons recorded in writing,
direct that the inspection of the affairs, of the insurance broker
be taken up without such notice.
(3)
The insurance broker shall allow the inspecting authority to have
full access to the premises occupied by such insurance broker or by
any other person on his behalf and also extend all facilities for
examining books, records, documents and computer data in the
possession of the insurance broker.
(4)
The inspecting authority, in the course of inspection, shall be
entitled to examine or record statements of any principal officer or
employee of the insurance broker and have the powers to seize or
make copies of documents/records.
(5)
It shall be the duty of every such person to give to the inspecting
authority all assistance in connection with the inspection which the
insurance broker may reasonably be expected to give.
(6)
Failure to comply with the requirements of the Authority in this
regard or failure to co-operate with the inspecting officers shall
result in suspension of licence.
31.
Submission of report to the Authority
The
inspecting authority shall submit an inspection report to the
Authority within 90 days of the completion of the inspection.
32.
Communication of findings, etc.
(1)
The Authority shall, after consideration of the inspection report,
communicate its findings to the insurance broker and give him a
reasonable opportunity of being heard before any action is taken by
the Authority on the findings of the inspecting authority.
(2)
On receipt of the explanation, if any, from the insurance broker,
the Authority may direct the insurance broker to take such measures
as the Authority may deem fit.
33.
Appointment of investigator
(1)
The Authority may appoint a chartered accountant or an actuary or
any qualified and experienced individual in the field of insurance
to investigate the books of accounts or the affairs of the insurance
broker :
PROVIDED
that the person so appointed shall have the same powers of the
inspecting authority as are mentioned in regulation 29 and the
obligations of the insurance broker in regulation 29 shall be
applicable to the investigation under this regulation.
Explanation :
For the purposes of this regulation, the expression "chartered
accountant" shall have the same meaning as given in section 226
of the Companies Act, 1956 (1 of 1956), and the expression
"actuary" shall mean a member of the Actuarial Society of
India.
(2)
The expenses and costs of such an investigation shall be recovered
by the Authority from the insurance broker whose affairs had been
caused to be investigated.
34.
Cancellation or suspension of licence with notice
(1)
The licence of an insurance broker may be cancelled or suspended
after due notice and after giving him a reasonable opportunity of
being heard if he--
(a)
violates the provisions of the Insurance Act, 1938 (4 of 1938),
Insurance Regulatory and Development Authority Act, 1999 (41 of
1999) or rules or regulations made thereunder;
(b)
fails to furnish any information relating to his activities as an
insurance broker as required by the Authority;
(c)
furnishes wrong or false information; or conceals or fails to
disclose material facts in the application submitted for obtaining a
licence;
(d)
does not submit periodical returns as required by the Authority;
(e)
does not co-operate with any inspection or enquiry conducted by the
Authority;
(f)
fails to resolve the complaints of the policy holders or
fails to give a satisfactory reply to the Authority in this behalf;
(g)
indulges in rebates or inducements in cash or kind to a client or
any of the client's directors or other employees or any person
acting as an introducer;
(h)
is found guilty of misconduct or his conduct is not in accordance
with the code of conduct specified in Schedule III;
(i)
fails to maintain the capital requirements in accordance with
the provisions of regulation 10;
(j)
fails to pay the fees or the reimbursement of expenses under
these regulations;
(k)
violates the conditions of licence;
(l)
does not carry out his obligations as specified in the
regulations;
(m)
if the principal officer does not acquire practical training
and pass the examination within the stipulated period as specified
in regulation 9.
(2)
In the circumstances where the Authority feels that the
establishment of an insurance broker is only to divert funds within
a group of companies or their associates, it can after due enquiries
made by it cancel the licence granted to the insurance broker.
35.
Cancellation or suspension of licence without notice
The
licence of an insurance broker may be cancelled or suspended without
notice, if he--
(a)
violates any one or more of the requirements under the code
of conduct specified in Schedule III;
(b)
is found guilty of fraud, or is convicted of a criminal
offence;
(c)
commits such defaults, which require immediate action in the
opinion of the Authority, provided that the Authority has
communicated the reasons for the cancellation in writing;
(d)
the insurance broker has not commenced the business within
six months of being granted a licence.
36.
Manner of making order of cancellation/suspension with notice
The
licence of an insurance broker shall not be cancelled unless an
enquiry has been held in accordance with the procedure specified in
regulation 37.
37.
Manner of holding enquiry before suspension or cancellation
(1)
For the purpose of holding an enquiry under regulation 36, the
Authority may appoint an enquiry officer.
(2)
The enquiry officer shall issue to the insurance broker a notice at
the registered office or the principal place of business of the
insurance broker, as the case may be, calling for such information
as he considers necessary for the conduct of an enquiry.
(3)
The insurance broker may, within fifteen days from the date of
receipt of such a notice, furnish to the enquiry officer a reply
together with copies of documentary or other evidence relied on by
him or sought by the enquiry officer.
(4)
The enquiry officer shall give a reasonable opportunity of hearing
to the insurance broker to enable him to make submissions in support
of his reply made under sub-regulation (3).
(5)
The insurance broker may either appear in person or through any
person duly authorised by him to present its case.
(6)
If it is considered necessary, the enquiry officer may require the
Authority to present its case through one of its officers, and
(7)
The enquiry officer shall, after taking into account all relevant
facts and submissions made by the insurance broker, submit a report
to the Authority within 90 days of the completion of the enquiry
proceedings.
38.
Show-cause notice and order
(1)
On receipt of the report from the enquiry officer, the Authority
shall consider it and issue a show-cause notice to the insurance
broker if the contents of the report warrant a suspension or
cancellation of the licence granted to him:
PROVIDED
that no such notice is required, in case the provisions of
regulation 35 are attracted.
(2)
The insurance broker shall within twenty-one days of the date of
receipt of the show-cause notice send a reply to the Authority.
(3)
The Authority after considering the reply to the show cause notice
shall, as soon as possible, but not later than thirty days from the
receipt of the reply, pass such an order as it deems fit :
PROVIDED
however, where the insurance broker on serving of the notice under
this regulation fails to furnish any reply within the stated period,
the Authority may after the expiry of such time proceed to decide
the case ex parte.
(4)
The Authority shall send a copy of the order made under clause (3)
to the insurance broker.
39.
Publication of order of suspension or cancellation
The
order of cancellation or suspension of the licence made under
sub-regulation (3) of regulation 38, shall be published in one of
the daily newspapers in the English language and one newspaper in
the regional language as the Authority may consider fit.
40.
Effect of cancellation or suspension of licence
(1)
On and from the date of suspension or cancellation of the licence,
the insurance broker shall cease to act as an insurance broker.
(2)
An insurance broker however shall continue to service the contracts
already concluded through him for a period of six months within
which suitable arrangements shall be made by him for having the
contracts attended to by another licensed insurance broker.
(3)
The Authority in such an event may pass such an order as it thinks
fit for the disposal of the deposit of the insurance broker made
under regulation 22.
41.
General
(1)
From the date of commencement of these regulations no person can
function as a broker or an insurance intermediary unless a licence
has been granted to him by the Authority under these regulations.
(2)
Any disputes arising between an insurance broker and an insurer or
any other person either in the course of his engagement as an
insurance broker or otherwise may be referred to the Authority by
the person so affected; and on receipt of the complaint or
representation, the Authority may examine the complaint and if found
necessary proceed to conduct an enquiry or an inspection or an
investigation in terms of these regulations.
SCHEDULE I
FORM
A
[Refer
regulations 6 and 13]
INSURANCE
REGULATORY AND DEVELOPMENT AUTHORITY
(INSURANCE BROKERS) REGULATIONS, 2002
Application
for grant of Licence/renewal of Licence
Name of the applicant : |
.................................. |
Address : |
.................................. |
Category applied
for : |
Insurance
broker ............
(Mention category)
|
Contact
address : |
.................................. |
Telephone No. : |
.................................. |
Fax No. : |
.................................. |
E-mail : |
.................................. |
Instructions for filling up the form:
1. It is important that before this application form is filled
in, the regulations made by the Authority are studied carefully.
2. Applicants must submit a duly completed application form
together with all appropriate, supporting documents to the
Authority.
3. Application for licence will be considered only if it is
complete in all respects.
4. Applicants should sign the applications themselves.
5. Information which needs to be supplied in more details may be
given on separate sheets which should be attached to the application
form.
6. If the applicant is not a proprietary concern, firm or a
company, the information called for in this Form shall be supplied
by adapting the requirements suitably.
PARTICULARS
OF THE APPLICANT
1.1
Name of the applicant : ..................................
1.2
(A) Address - principal place of business/registered office
:......
Pin Code
:..................................
|
Telephone No......
|
E-mail :..........................
|
Fax No. ................
|
(B) Address for
correspondence:...........................................
Pin Code ........................... |
Telephone No......
|
E-mail :..........................
|
Fax No. ................
|
(C)
Address of branch offices :.................................
(D)
Name and designation of the principal officer :............
2. Organisation - structure
2.1 Status of the applicant :
(e.g.
limited company - private/public partnership, proprietary, others.
If listed, names of stock exchanges and latest shares price to be
given)
2.2 Date and place of incorporation :
Day
Month Year
Place
2.3 Scope of business as described in the memorandum of
association :
(To
be given in brief along with copy of memorandum and articles of
association or partnership deed).
2.4
List of major shareholders (holding 5 per cent and above of
applicant directly or along with associates - applicable only to
limited companies) :
Shareholding
as on : ............
Name
of shareholder
|
No. of
shares held
|
% age
of total paid up capital of the company
|
|
|
|
2.5
Particulars of all directors/partners/proprietor :
Name
|
Qualification
|
Experience
in insurance broking services and related areas
|
Share
in applicant firm-company
|
Directorship
in other companies
|
|
|
|
|
|
2.6
Name and activities of associate companies/concerns:
Name
of company/firm
|
Address
|
Type
of activity handled
|
Nature
of interest of promoter/director
|
Nature
and interest of applicant company
|
|
|
|
|
|
Whether
any one or more persons of the associate companies/concerns are
interested in the applicant's business.
2.7 Name and address of the principal bankers of the applicant:
2.8 Name and address of the statutory auditors:
3. Business information
3.1
Three years business plan document with projected volume of
activities and income (including anticipated) for which licence
sought is to be specifically given:
3.2
Organisation chart separately showing functional
responsibilities to be enclosed:
3.3 Particulars of key management personnel :
Name
|
Qualification
|
Experience
with particular reference to insurance broking/insurance consulting
activities
|
Date
of appointment
|
Functional
areas
|
|
|
|
|
|
3.4
Details of infrastructure like office space, equipment and
manpower available with the applicant:
3.5
Details of experience in insurance broking/insurance
consulting/risk management and other services:
[History,
major events and present activities (Experience outside India may
also be indicated)]
3.6
Business handled during the last three years and list of
re-insurers with whom more than ten per cent of the total
re-insurance premium handled, was placed:
Sl. No.
|
Name
|
Premium
handled
|
Services
rendered
|
Amount
|
Percentage
of total premium handled by broker
|
|
|
|
|
|
|
|
|
|
|
3.7
Any other information considered relevant to the nature of
services rendered by the applicant:
4. Financial information
4.1 Capital structure
(Rs.
in lakhs)
Capital
structure
|
Year
prior to the preceding year of current year
|
Preceding
year
|
Current
year
|
(a) Authorised
capital and issued capital
|
|
|
|
(b) Paid-up capital |
|
|
|
(c) Free reserves
(excluding revaluation reserves) |
|
|
|
(d) Total (b)
+ (c) |
|
|
|
Notes
:
1.
In case of partnership or proprietary concern, please
indicate capital minus drawings and/or loans to partners/owners.
2.
In case of partnership or proprietary concerns, please
indicate the financial position, means and net worth of the
partners.
4.2 Deployment of resources
(Rs.
in laks)
Particulars
|
Year
prior to the preceding year of current year
|
Preceding
year
|
Current
year
|
(a) Fixed assets |
|
|
|
(b) Plant and machinery |
|
|
|
(c) Office equipment |
|
|
|
(d) Quoted investments |
|
|
|
(e) Unquoted investments |
|
|
|
(f) Details of liquid assets |
|
|
|
(g) Others |
|
|
|
(Details
of investments, loans and advances made to associate companies/firms
where promoters/directors have an interest is to be separately
given).
4.3 Major sources of income
(Rs.
in lakhs)
Particulars
|
Year prior
to the preceding year of current year |
Preceding year
|
Remuneration
received as % of premium |
(a) Direct insurance
remuneration |
|
|
|
(b) Re-insurance
remuneration |
|
|
|
(c) Advisory fees |
|
|
|
(d) Insurance
consultancy |
|
|
|
(e) Investment
income |
|
|
|
(f) Details of
liquid assets |
|
|
|
(g) Others |
|
|
|
As
remuneration received by the insurance broker may vary from risk to
risk, please indicate range within which remuneration has been
received.
4.4 Income and profit before tax (PBT)
(Rs.
in lakhs)
Particulars
income profit before tax
|
Year
prior to the preceding year of current year
|
Preceding
year
|
Current
year
|
|
|
|
|
4.5 Dividend
(Rs. in lakhs)
Particulars
|
Year
prior to the preceding year of current year
|
Preceding
year
|
Current
year
|
Amount |
|
|
|
Percentage |
|
|
|
Year prior
to the preceding year of current year Preceding year Current year
Note
: Please enclose
three years audited annual accounts.
Where unaudited reports are submitted, give reasons.
If minimum capital requirement has been met after last
audited annual accounts, audited statement of accounts for the
period ending on a later date should also be submitted.
5.
Other information, if any
5.1
Details of all settled and pending disputes:
Name
of dispute
|
Name
of the party
|
Pending/Settled
|
|
|
|
5.2
Details, if any of any economic offences by the
applicant/proprietor or any of the partners/directors, or key
managerial personnel in the last three years.
DECLARATION
This
declaration is to be signed by two of the directors, two of the
partners or the sole proprietor as the case may be.
I/We
hereby apply for licence.
I/We
have gone through the Insurance Regulatory and Development Authority
(Insurance Brokers) Regulations, 2002, and am/are satisfied that
I/We am/are eligible to apply for the insurance broker's licence.
I/We
state that I/We have truthfully and fully answered the questions
above and provided all the information which might reasonably be
considered relevant for the purposes of my/our licence.
I/We
declare that the information supplied in the application form is
complete and correct.
I/We
undertake that I/We shall not allow or offer to allow, either
directly or indirectly, as an inducement to any person, any rebate
of the whole or part of the remuneration earned by me/us during the
licence period.
I/We
undertake to service the run-off business on the books at the time
of cancellation or non-renewal of licence.
I/We
declare that I/We do not possess an insurance
agent licence under section 42 of the Act.
For
and on behalf of
...........................
(Signature and name of applicant)
Block letters
..................................
.................................................
(Signature and name of applicant)
Block
letters
.
Director/partner
or sole proprietor
Director/partner
Place :
Date :
INSURANCE
REGULATORY AND DEVELOPMENT AUTHORITY
(INSURANCE BROKERS) REGULATIONS, 2002
FORM B
[Refer
regulations 11 and 16]
LICENCE
1.
In exercise of the powers conferred by sub-section (1) of section
42D of the Insurance Act, 1938 (4 of 1938) the Authority hereby
grants a licence to ............. to act as
.............................. (mention details of category) broker
under that Act.
2.
Licence Code for the insurance broker is ...........................
3.
This licence shall be valid from ....... to .........
4.
This licence is subject to the Act, Insurance Regulatory and
Development Authority Act, 1999 (41 of 1999) and Insurance
Regulatory and Development Authority (Insurance Brokers)
Regulations, 2002 and shall not be construed to be in compliance
with or in conformity to an other Act, rules or regulations.
Place :
By
Order
Date :
For and on behalf of
Insurance Regulatory and Development Authority
SCHEDULE II
INSURANCE
REGULATORY AND DEVELOPMENT AUTHORITY
(INSURANCE BROKERS) REGULATIONS, 2002
[Refer
regulation 18]
FEES
REGISTRATION
FEES :
1.(a) Every insurance broker at the time of being licensed shall
pay licence fees as set out below:
Category
of insurance broker
|
Amount
of licence fee payable (Rs.)
|
Direct broker |
25,000
|
Re-insurance broker |
75,000
|
Composite broker |
1,25,000
|
(b) The licence fee as prescribed above shall be paid within 15
days from the date of receipt of intimation under regulation 11.
2.
Every insurance broker at the time of renewal of licence shall pay
licence fees as set out below :
Category
of insurance broker
|
Amount
of licence fee payable per annum
|
Direct broker |
A sum calculated at the rate
of 0.50 per cent of remuneration earned in the preceding financial
year subject to minimum of Rs. 25,000 and maximum of Rs. 1,00,000
on every renewal. |
Re-insurance
broker |
A sum calculated at the rate
of 0.50 per cent of remuneration earned in the preceding financial
year subject to minimum of Rs. 75,000 and maximum of Rs. 30,00,000
on every renewal. |
Composite broker |
A sum calculated at the rate
of 0.50 per cent of remuneration earned in the preceding financial
year subject to minimum of Rs. 1,25,000 and maximum of Rs. 5,00,000
on every renewal. |
3.
The licence fee shall be paid before the expiry of 15 days of the
licence granted under regulation 11.
4.
The fees shall be payable by an Account Payee draft in favour of
"The Insurance Regulatory and Development Authority"
payable at Hyderabad.
SCHEDULE III
INSURANCE
REGULATORY AND DEVELOPMENT AUTHORITY
(INSURANCE BROKERS) REGULATIONS, 2002
CODE
OF CONDUCT
[Refer
regulation 21]
1.
Every insurance broker shall follow recognized standards of
professional conduct and discharge his functions in the interest of
the policyholders.
2.
Conduct in matters relating to clients relationship
Every
insurance broker shall,--
(a) conduct its dealings with clients with utmost good faith and
integrity at all times;
(b) act with care and diligence;
(c) ensure that the client understands his relationship with the
broker and on whose behalf the broker is acting;
(d) treat all information supplied by the prospective clients as
completely confidential to themselves and to the insurer(s) to which
the business is being offered;
(e) take appropriate steps to maintain the security of
confidential documents in their possession;
(f) hold specific authority of client to develop terms;
(g) understand the type of client it is dealing with and the
extent of the client's awareness of risk and insurance;
(h) obtain written mandate from client to represent the client to
the insurer and communicate the grant of a cover to the client after
effecting insurance;
(i) obtain written mandate from client to represent the client to
the insurer/re-insurer; and confirm cover to the insurer after
effecting re-insurance, and submit relevant re-insurance acceptance
and placement slips;
(j) avoid conflict of interest.
3.
Conduct in matters relating the sales practices
Every
insurance broker shall,--
(a) confirm that it is a member of the Insurance Brokers
Association of India or such a body of brokers as
approved by the
authority which has a memorandum of understanding with the
Authority;
(b) confirm that he does not employ agents or canvassers to bring
in business;
(c) identify itself and explain as soon as possible the degree of
choice in the products that are on offer;
(d) ensure that the client understands the type of service it can
offer;
(e) ensure that the policy proposed is suitable to the needs of
the prospective client;
(f) give advice only on those matters in which it is
knowledgeable and seek or recommend other specialist for advice when
necessary;
(g) not make inaccurate or unfair criticisms of any insurer or
any member of the
Insurance Brokers Association of India or member of such body of
brokers as approved by the Authority;
(h) explain why a policy or policies are proposed and provide
comparisons in terms of price, cover or service where there is a
choice of products;
(i) state the period of cover for which the quotation remains
valid if the proposed cover is not effected immediately;
(j) explain when and how the premium is payable and how such
premium is to be collected, where another party is financing all or
part of the premium, full details shall be given to the client
including any obligations that the client may owe to that party; and
(k) explain the procedures to follow in the event of a loss.
4.
Conduct in relation to furnishing of information
Every
issurance broker shall,--
(a) ensure that the consequences of non-disclosure and
inaccuracies are pointed out to the prospective client;
(b) avoid influencing the prospective client and make it clear
that all the answers or statements given are the latter's own
responsibility. Ask the client to carefully check details of information
given in the documents and request the client to make true, fair and
complete disclosure where it believes that the client has not done
so and in case further disclosure is not forthcoming it should
consider declining to act further;
(c) explain to the client the importance of disclosing all
subsequent changes that might affect the insurance throughout the
duration of the policy; and
(d) disclose on behalf of its client all material facts within
its knowledge and give a fair presentation of the risk.
5.
Conduct in relation to explanation of insurance contract
Every
insurance broker shall,--
(a) provide the list of insurer(s) participating under the
insurance contract and advise any subsequent changes thereafter;
(b) explain all the essential provisions of the cover afforded by
the policy recommended by him so that, as far as possible, the
prospective client understands what is being purchased;
(c) quote terms exactly as provided by insurer;
(d) draw attention to any warranty imposed under the policy,
major or unusual restrictions, exclusions under the policy and
explain how the contract may be cancelled;
(e) provide the client with prompt written confirmation that
insurance has been effected. If
the final policy wording is not included with this confirmation, the
same shall be forwarded as soon as possible;
(f) notify changes to the terms and conditions of any insurance
contract and give reasonable notice before any changes take effect;
(g) advise its clients of any insurance proposed on their behalf
which will be effected with an insurer outside India, where
permitted, and, if appropriate, of the possible risks involved.
6.
Conduct in relation to renewal of policies
Every
insurance broker shall,--
(a) ensure that its
client is aware of the expiry date of the insurance even if it
chooses not to offer further cover to the client;
(b) ensure that renewal notices contain a warning about the duty
of disclosure including the necessity to advise changes affecting
the policy, which have occurred since the policy inception or the
last renewal date;
(c) ensure that renewal notices contain a requirement for keeping
a record (including copies of letters) of all information supplied
to the insurer for the purpose of renewal of the contract;
(d)
ensure that the client receives the insurer's renewal
invitation well in time before the expiry date.
7.
Conduct in relation to claim by client
Every
insurance broker shall,--
(a) explain to its clients their obligation to notify claims
promptly and to disclose all material facts and advise subsequent
developments as soon as possible;
(b) request the client to make true, fair and complete disclosure
where it believes that the client has not done so.
If further disclosure is not forthcoming it shall consider
declining to act further for the client;
(c) give prompt advice to the client of any requirements
concerning the claim;
(d)
forward any information received from the client regarding a
claim or an incident that may give rise to a claim without delay,
and in any event within three working days;
(e) advise the client without delay of the insurer's decision or
otherwise of a claim; and give all reasonable assistance to the
client in pursuing his claim:
PROVIDED
that the insurance broker shall not take up recovery assignment on a
policy contract which has not been serviced through him or should
not work as a claims consultant for a policy which has not been
serviced through him.
8.
Conduct in relation to receipt of complaints
Every
insurance broker shall,--
(a) ensure that letters of instruction, policies and renewal
documents contain details of complaints handling procedures;
(b) accept complaints either by phone or in writing;
(c) acknowledge
a complaint within fourteen days from the receipt of correspondence,
advise the member of staff who will be dealing
with the complaint and the time-table for dealing with it;
(d) ensure that response letters are sent and inform the
complainant of what he may do if he is unhappy with the response;
(e)
ensure that complaints are dealt with at a suitably senior
level;
(f)
have in place a system for recording and monitoring
complaints.
9.
Conduct in relation to documentation
Every
insurance broker shall,--
(a) ensure that any documents issued comply with all statutory or
regulatory requirements from time to time in force;
(b) send policy documentation without avoidable delay;
(c) make available, with policy documentation, advice that the
documentation shall be read carefully and retained by the client;
(d) not withhold documentation from its clients without their
consent, unless adequate and justifiable reasons are disclosed in
writing and without delay to the client.
Where documentation is withheld, the client must still
receive full details of the insurance contract;
(e)
acknowledge receipt of all monies received in connection with
an insurance policy;
(f)
ensure that the reply is sent promptly or use its best
endeavours to obtain a prompt reply all correspondence;
(g)
ensure that all written terms and conditions are fair in
substance and set out, clearly and in plain language, client's
rights and responsibilities; and
(h)
subject to the payment of any monies owed to it, make
available to any new insurance broker instructed by the client all
documentation to which the client is entitled and which is necessary
for the new insurance broker to act on behalf of the client.
10.
Conduct in matters relating to advertising
Every
insurance broker shall conform to the relevant provisions of the
Insurance Regulatory and Development Authority (Insurance
Advertisements and Disclosure) Regulations, 2000, and--
(a)
ensure that statements made are not misleading or
extravagant;
(b)
where appropriate, distinguish between contractual benefits
which the insurance policy is bound to provide and non-contractual
benefits which may be provided;
(c)
ensure that advertisements shall not be restricted to the
policies of one insurer, except where the reasons for such
restriction are fully explained with the prior approval of that
insurer;
(d)
ensure that advertisements contain nothing which is in breach
of the law nor omit anything which the law requires;
(e)
ensure that advertisement does not encourage or condone
defiance or breach of the law;
(f)
ensure that advertisements contain nothing which is likely,
in the light of generally prevailing standards of decency and
propriety, to cause grave or widespread offence or to cause
disharmony;
(g)
ensure that advertisements are not so framed as to abuse the
trust of clients or exploit their lack of experience or knowledge;
(h)
ensure that all descriptions, claims and comparisons, which
relate to matters of objectively ascertainable fact shall be capable
of substantiation.
11.
Conduct in matters relating to receipt of remuneration
Every
insurance broker shall,--
(a)
disclose whether in addition to the remuneration prescribed
under these regulations, he proposes to charge the client, and if so
in what manner;
(b)
advise the client in writing of the insurance premium and any
fees or charges separately and the purpose of any related services;
(c)
if requested by a client, disclose the amount of remuneration
or other remuneration it receives as a result of effecting insurance
for that client. This
will include any payment received as a result of securing on behalf
of the client any service additional to the arrangement of the
contract of insurance; and
(d)
advise its clients, prior to effecting the insurance, of
their intention to make any deductions from the amount of claim
collected for a client, where this is a recognised practice for the
type of insurance concerned.
12.
Conduct in relation to matters relating to training
Every
insurance broker shall,--
(a)
ensure that its staff are aware of and adhere to the
standards expected of them by this code;
(b)
ensure that staff are competent, suitable and have been given
adequate training;
(c)
ensure that there is a system in place to monitor the quality
of advice given by its staff;
(d)
ensure that members of staff are aware of legal requirements
including the law of agency affecting their activities and only
handle classes of business in which they are competent;
(e)
draw the attention of the client to section 41 of the Act,
which prohibits rebating and sharing of commission.
13.
Every insurance broker shall display in every office where it is
carrying on business and to which the public have access a notice to
the effect that a copy of the code of conduct is available upon
request and that if a member of the public wishes to make a
complaint or requires the assistance of the Authority in resolving a
dispute, he may write to the Authority.
14.
An insurance broker as defined in these regulations shall not act as
an insurance agent of any insurer under section 42 of the Act.
15.
Every insurance broker
shall abide by the provisions of the Insurance Act, 1938 (4 of
1938), Insurance Regulatory and Development Authority Act, 1999 (41
of 1999), rules and regulations made thereunder which may be
applicable and relevant to the activities carried on by them as
insurance brokers.
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