INSURANCE
REGULATORY AND DEVELOPMENT AUTHORITY (LINKED INSURANCE PRODUCTS) REGULATIONS,
2013 [REPEAL]
PREAMBLE
In exercise of the powers
conferred under 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, the Authority in consultation with the Insurance Advisory Committee,
hereby makes the following regulations, namely:
CHAPTER I Preliminary
Regulation 1. Short title and commencement.
(a)
These regulations may be called Insurance Regulatory and
Development Authority (Linked Insurance Products) Regulations, 2013.
(b)
They shall come into force on the date of their publication in the
Official Gazette.
(c)
These regulations shall be applicable to all linked insurance
products offered by life insurance companies.
(d)
Unless otherwise provided by these regulations, nothing in these
regulations shall deem to invalidate the linked insurance policies entered
prior to these regulations coming into force.
(e)
Regulations shall mean Insurance Regulatory and Development
Authority (Linked Insurance Products) Regulations, 2013.
(f)
For the purpose of this Regulation, the unit fund shall be read as
the policy account unless otherwise specified in case of variable insurance
products.
Regulation 1A. Definitions.
In these Regulations,
unless the context otherwise requires,
(a)
"Act" means the Insurance Act, 1938 (4 of 1938).
(b)
"Authority" means the Insurance Regulatory and
Development Authority established under sub-section (1) of section 3 of the
Insurance Regulatory and Development Authority Act, 1999 (41 of 1999)
(c)
"Allocation" means the process of creating the units at
the prevailing unit price offered by the life insurer like when the premiums
are received or when switches are made.
(d)
"Date of payment of premium" means the date on which
premium payment is received by the insurer in accordance with the provisions of
Section 64 VB (2) of the Act.
(e)
"Date of discontinuance of the policy" means, for the
purpose of these regulations, the date on which the insurer receives the
intimation from the insured or policyholder about discontinuance of the policy
or surrender of the policy or on the expiry of the notice period provided for
in the sub-regulation (i) of Regulation 13 (a) herein, whichever is earlier.
(f)
"Discontinuance" means the state of a policy that could
arise on account of surrender of the policy or non-payment of the contractual
premium due before the expiry of the notice period provided for stipulated in
sub regulation (i) of Regulation 13 (a) herein.
(g)
Provided that no policy shall be treated as discontinued on
non-payment of the said premium if, within the grace period, the premium has
not been paid due to the death of the insured or upon the happening of any
other contingency covered under the policy.
(h)
"Death benefit" means the benefit, agreed at the
inception of the contract, which is payable on death as specified in the policy
document.
(i)
"Discontinued Policy Fund/Discontinued Policy Account
Value" means the segregated fund/policy account of the insurer that is set
aside and is constituted by the fund value/policy account value, as applicable,
of all the discontinued policies determined in accordance with this Regulation.
(j)
"Discontinuance charge" means a charge that does not
exceed the limits stipulated in sub-regulation (vi) of regulation 13 (a)
herein, expressed as a percentage of one annualized level premium or the single
premium or fund value/policy account value, as applicable, that can be levied
upon discontinuance of a policy.
(k)
"Employer-Employee group" means groups where an
employer-employee relationship exists between the master policyholder and the
member in accordance with the relevant laws.
(l)
"Fund value or Unit Fund value" means the total value of
the units at that point of time in a segregated fund i.e. total number of units
under a policy multiplied by the Net Asset Value (NAV) per unit of that fund.
(m)
"Free-look" period shall be as stipulated in
sub-regulation 2 of Regulation 6 of Insurance Regulatory and Development
Authority (Protection of Policyholders' Interests) Regulations, 2002.
(n)
"Grace Period" means the time granted by the insurer
from the due date for the payment of premium, without any penalty/late fee,
during which time the policy is considered to be in-force with the risk cover
without any interruption as per the terms of the policy.
(o)
"Limited premium payment products" means the linked
insurance products where the premium payment period is limited compared to the
policy term and are paid at regular intervals like yearly, half-yearly etc.
(p)
"Lock-in-period" means the period of five consecutive
years from the date of commencement of the policy, during which period the
proceeds of the discontinued policies cannot be paid by the insurer to the
policyholder or to the insured, as the case may be, except in the case of death
or upon the happening of any other contingency covered under the policy.
(q)
"Maturity benefit" means the benefit which is payable on
maturity i.e. at the end of the term, as specified in the policy document and
is stated at the inception of the contract.
(r)
"Net Asset Value (NAV)" means the price per unit of the
Segregated Fund.
(s)
"Partial Withdrawals" means any part of fund/partial
withdrawal that is encashed/withdrawn by the policyholder during the period of
contract.
(t)
"Premium re-direction" means an option which allows the
policyholder to modify the allocation of amount of renewal premium to various
segregated funds, under a unit linked policy, offered through a different
investment pattern from the option exercised at the inception of the contract.
(u)
"Redemption" means cancellation of the units at the
prevailing unit price of the segregated funds offered in the products, in case
of partial withdrawals, switches, surrender, maturity etc.
(v)
"Regular Premium Products" means linked insurance
products where the premium payment is throughout the term of the product and
are paid in regular intervals like yearly, half-yearly etc.
(w)
"Rider benefits" means an amount of benefit payable on a
specified event offered under the rider, and is allowed as add-on benefit to
main benefit.
(x)
"Revival of a policy" means restoration of the policy,
which was discontinued due to the non-payment of premium, by the insurer with
all the benefits mentioned in the policy document, with or without rider
benefits if any, upon the receipt of all the premiums due and other charges if
any, as per the terms and conditions of the policy, upon being satisfied as to
the continued insurability of the insured on the basis of the information,
documents and reports furnished by the policyholder, in accordance with their
Board approved Underwriting guidelines.
(y)
"Revival Period" means the period of two consecutive
years from the date of discontinuance of the policy, during which period the
policyholder is entitled to revive the policy which was discontinued due to the
non-payment of premium.
(z)
"Segregated fund" means the funds as referred to in
Schedule II-A of the IRDA (Assets, Liabilities and Solvency Margin of the
Insurers) Regulations, 2000.
(aa)
"Sales illustrations" means a document furnished in accordance
with life insurance council circular number LC/SP/Ver 1.0 dated 3rd February,
2004, which depicts the effect of charges on the value of benefits at various
stages of a linked contract. The illustrations furnished for these contracts
shall inter alia furnish the yield, net of charges, corresponding to both the
higher and lower interest rate scenario.
(bb)
"Settlement options" means a facility made available to
the policyholder under the unit linked products to receive the maturity
proceeds in installments in accordance with the terms and conditions specified
in advance at the inception of the contract.
(cc)
"Single premium products" means linked insurance
products, where the premium payment is made by a single payment at the
inception of the policy.
(dd)
"Sum Assured" means an absolute amount of benefit which
is guaranteed to become payable on death of the life assured in accordance with
the terms and conditions of the policy or an absolute amount of benefit which
is available to meet the health cover.
(ee)
"Surrender" means complete withdrawal/termination of the
entire policy.
(ff)
"Surrender Value" means an amount, if any, that becomes
payable in case of surrender in accordance with the terms and conditions of the
policy.
(gg)
"Switches" means a facility allowing the policyholder to
change the investment pattern by moving from one segregated fund, either wholly
or in part, to other segregated fund(s) amongst the segregated funds offered
under the underlying unit linked product of the insurer.
(hh)
"Top-up premium" means an additional amount (s) of
premium paid, if any, over and above the contractual basic premiums stipulated
in the terms and conditions, at irregular intervals during the period of
contract.
(ii)
"Units" means a specific portion or part of the
underlying segregated unit finked fund which is representative of the
policyholder's entitlement in such funds.
ii) "Linked Whole Life
products" means linked insurance products which do not have a definite
policy term and the policy terminates on death of the life assured. This can be
issued with item (n) or (u) or (bb) stated above.
(jj)
All words or expressions not defined in these regulations but
defined in the Insurance Act 1938 or Insurance Regulatory and Development
Authority Act 1999 shall have the same meanings respectively assigned to them
in those Acts.
CHAPTER-II
Linked Insurance Products
Regulation 2. Linked insurance products.
(a)
Linked insurance products shall be offered only under non-par
individual products and non-par fund based group products in any of the
following manner:
(i)
Unit Linked Products and
(ii)
Variable Linked Products.
Regulation 3. Unit Linked Insurance Products (ULIP).
(a)
Unit Linked insurance products shall be offered in any of the
following manner:
(i)
Linked Individual Non-par;
(ii)
Linked Fund based Group Non-par;
(b)
These are the products where the benefits are partially or wholly
dependent on the performance of the underlying assets under each of the
segregated fund offered and shall be operated as follows:
(i)
The premiums shall be allocated to such segregated funds,
otherwise called as unit funds, as per its net asset value and the benefits
shall he determined based on the performance of the underlying assets of such
segregated funds.
(ii)
The insurers may levy charges as stipulated in Regulation 35
herein applicable to the unit linked products.
(iii)
The products shall comply with the maximum reduction in yield
requirements as referred stipulated in Regulation 37 herein.
(c)
A unit linked policy may only offer the following death benefits:
(i)
The sum assured as agreed in the policy plus the balance in the
unit fund or
(ii)
Higher of the sum assured as agreed in the policy or the balance
in the unit fund.
In either case, the sum assured
shall be at a minimum consistent with the provision stipulated in Regulation 5
herein.
(d)
A minimum maturity benefit which shall be at least equal to the
balance in the unit fund on the date of maturity.
Regulation 4. Variable Linked Insurance Products (VLIP).
(a)
Variable insurance products shall be offered in any of the
following manner:
(i)
Linked Individual Non-par;
(ii)
Linked Fund based Group Non-par;
(b)
These are the products where the benefits are partially or wholly
dependent on the performance of an approved external index/benchmark which is
linked to the product and shall be operated as follows:
(i)
The Variable insurance products shall have a:
(1)
Guaranteed non-negative interest rate, referred as minimum floor
rate and
(2)
Non-negative variable interest rate of not less than quarterly
frequency, which shall be directly linked to the performance of the approved
external index or the external benchmark.
(3)
Non-negative residual additions, if any, shall be credited to the
policy account in order to meet the maximum reduction in yield as stipulated in
Regulation 37 at the end of each year starting from policy year 5. Such
non-negative residual additions shall be determined as:
(a)
Gross Investment Yield earned in the shadow account at the end of
each policy year less
(b)
Actual yield earned in the policy account value, at the end of
each policy year less
(c)
Yield referred in the reduction in yield at that duration as per
Regulation 37
(d)
For the purpose of this regulation, the yield earned on each of
the Policy account shall be calculated using the money weighted rate of return
method at end of each policy year.
(ii)
This minimum floor rate, as approved in the File and Use clearance
accorded by the Authority, shall be:
(1)
Guaranteed for the entire term of the policy accumulating on the
balance of the policy account;
(2)
Such accumulation shall be at a frequency of not less than
quarterly on the balance of the policy account at the beginning of each such
quarter.
(iii)
At each interval, after the minimum floor rate is credited, the
non-negative variable interest rate, as applicable, in accordance with the
external index or external benchmark, as approved in the File and Use clearance
accorded by the Authority, shall be credited to the balance of the policy
account value and
(iv)
At the end of each policy year, in order to comply with maximum
reduction in yield as stipulated in Regulation 37 herein, after minimum floor
rate and non-negative variable interest rate are credited, non-negative
residual additions, if any shall be credited to the policy account value.
(c)
Variable linked policy may only offer the following death
benefits:
(i)
The sum assured as agreed in the policy plus the balance in the policy
account or
(ii)
Higher of the sum assured as agreed in the policy or the balance
in the policy account.
In either case, the sum assured
shall be at a minimum consistent with the provision stipulated In Regulation 5
herein and
(iii)
A minimum maturity benefit which shall be at least equal to the
balance in the policy account.
(iv)
Policy Account Value:
(1)
Every variable linked insurance policy shall have a corresponding
policy account whose balance shall depict the accrual to the policyholder. The
policy account shall be credited with premium net of charges as stipulated in
Regulation 35 herein, as applicable to variable insurance products. The
guaranteed rate and variable interest rate shall be applicable to the balance
of the policy account.
(2)
Shadow policy account value shall be maintained on a daily basis.
Such shadow policy account shall be computed based on the actual accruals of
all income elements like premiums, top-up premiums, income from investments as
and when received and all actual debits i.e. partial withdrawals to the policy
account value as and when debited, to arrive at the actual gross investment
return and reduction in yield to the policy account value, at the end of each
year starting from policy year 5.
(3)
The policy account value shall comply with the maximum reduction
in yield requirements as referred stipulated in Regulation 37 herein.
(v)
Frequency of accrual of non-negative variable interest rate: For
all modes of premium payment (viz., single premium, annual, half-yearly,
quarterly and monthly) the non-negative variable interest rate to be credited
shall not be less than quarterly frequency.
(vi)
Separation of assets:
(1)
The insurer shall keep a separate account of all receipts and
payments in respect of this product. The valuation of assets and liabilities
shall be in accordance with the IRDA (Assets, Liabilities and Solvency Margin)
Regulations, 2000 and all other relevant regulations.
(2)
The insurer shall earmark assets for each product separately and
the policy account value of each of the product shall be disclosed on a daily
basis in the website through a specifically assigned identification number
called "SAIN" where the SAIN shall start with the unique
identification number assigned to the product followed by a three digit running
number to be assigned to such products.
(3)
The insurer shall prepare the financial statements separately in
addition to the businesses mentioned in Part V of the Schedule-A of the
Insurance Regulatory and Development Authority (Preparation of Financial
Statements and Auditor's Report of Insurance Companies) Regulations, 2002.
(vii)
Furnishing Statements of Accounts;
(1)
The statement of policy account shall be sent to the policyholder
at least once a year.
(2)
Policy account statement shall be issued at the end of each
financial year to the policyholder giving the breakup of the Opening balance,
premium received, deductions towards charges, minimum floor interest earned,
variable interest earned, non-negative residual interest rate credited and
closing balance in the manner prescribed in the Annexure-I.
(viii) Approved
External Index: The external index so linked may be allowed to be changed only
on approval under File and Use under the following circumstances:
(1)
Such changes shall be allowed only in case of non-availability of
the existing index or disruption of existing index.
(2)
Any such subsequent changes shall be informed to the policyholder
at least with 1 month's notice and shall provide the policyholder/insured the
information about another approved external index, which shall be linked to the
product.
CHAPTER-III Benefits Payable on Death,
Benefits payable under Health cover and Guarantees
Regulation 5. Benefit payable on death/Benefits offered under the Health Cover.
(a) From
inception of the policy, all individual linked insurance products shall offer
at least the minimum sum assured as specified in the table 5.c that becomes
payable:
(i) on death
or
(ii) to make
benefits payments under the health cover, as applicable.
(b) The table
5.c below specifies the minimum sum assured under linked insurance products
where:
(i) T is Policy
Term chosen by the policyholder for any product except for whole life products.
(ii) For whole
life products, T shall be taken as 70 minus age at entry.
(iii) AP is
Annualized Premium selected by the policyholder at the inception of the policy
excluding the service tax.
(iv) SP is the
Single Premium which is chosen by the policyholder at the inception of the
policy, excluding the service tax.
(c) The
minimum sum assured shall be at least equal to:
Table 5.c
|
Type of Products
|
Minimum Sum assured for
age at entry below 45 years
|
Minimum Sum assured for
age at entry of 45 years and above
|
|
Life Single Premium (SP)
Products
|
125 percent of single
premium.
|
110 percent of single
premium
|
|
Life Regular Premium (RP)
including Limited Premium Paying (LPP) Products
|
10 times the annualized
premiums or (0.5 X T X annualized premium) whichever is higher.
|
7 times the annualized
premiums or (0.25 X T X annualized premium) whichever is higher.
|
|
Health Regular Premium
(RP) including Limited Premium Paying (LPP) products
|
5 times the annualized
premium or Rs. 100,000 per annum whichever is higher.
|
5 times the annualized
premium or Rs. 100,000 per annum whichever is higher.
|
(d) In
respect of pension products and immediate annuity products, the minimum sum
assured as in Table 5.c is not mandatory.
(e) Single
premium health insurance products shall not be offered under unit linked
insurance products.
(f) Other
Conditions:
(i) In case
of unit linked insurance products as stipulated in Regulation 3 (c)(ii) herein,
on death during the term of the policy, the sum assured payable on death shall
not be reduced, except to the extent of the partial withdrawals made during the
two year period Immediately preceding the death of the life assured. However,
on attainment of 60 years of age of the life assured, all the partial
withdrawals made within two years before attaining age 60 and all the partial
withdrawals made after attaining age 60 may be reckoned for adjusting out of
the sum assured to determine actual sum payable on death.
(ii) No cover
shall be extended after the expiry of the policy term and only settlement
options under unit linked products, which are clearly outlined at the
commencement of the contract, may be allowed.
(iii) In case
of death due to suicide, within 12 months from the date of inception of the
policy or from the date of revival of the policy, the nominee of the
policyholder shall be entitled to the fund value/policy account value, as
available on the date of death.
(iv) In case
fraud or misrepresentation, the policy shall be cancelled immediately by paying
the surrender value, subject to the fraud or misrepresentation being
established by the insurer in accordance with Section 45 of the Insurance Act,
1938.
(v) For
policies issued on minor life, the date of commencement of policy and date of
commencement of risk shall be same.
(g) At no
time the death benefit under a life insurance product or a benefit assured
under a pension product on death or a health related benefit under a health
insurance product shall be less than 105 percent of the total premiums
including top-ups paid, excluding the service tax.
Regulation 6. Guarantees on policy benefits.
(a) Subject
to provisions stipulated in Regulations 5, 26 and 33 herein, all individual
linked products shall have either a guaranteed sum assured payable on death or
a guaranteed sum assured to meet the health cover, as applicable and may have a
guaranteed maturity value.
(b) General
aspects on any investment guarantees provided under linked products:
(i) Guarantees
provided shall be reasonable, consistent in relation to the current and long
term interest rate scenario and priced appropriately.
(ii) In case
of unit linked products where guarantee charge is levied: If a guarantee charge
is levied for the guarantees offered, the insurer shall submit a comprehensive documentation
on such guarantee charge and demonstrate in their application under the File
and Use:
(1) the
purpose of such charge,
(2) the
pricing methodology adopted and reserving methodology proposed to be adopted,
(3) the
appropriateness of proper pricing and reserving through sensitivity and
scenario testing for all the guarantees provided for,
(4) the
possible asset allocations envisaged in arriving at the guarantee and the
corresponding charge,
(5) whether
such asset allocations envisaged as in (4) above and the actual assets
allocations underlying the fund could be different,
(6) how the
objective of the fund would be achieved in such scenario etc.,
(iii) In case
of variable insurance products, the insurer shall not levy any guarantee
charge.
CHAPTER-IV Policy Term, Premium Paying
Term & Commission
Regulation 7. Minimum Policy Term.
The
minimum policy term
(a) For
individual products, shall be at least five years and
(b) For fund
based group linked products, shall be on annually renewable basis.
Regulation 8. Premium Payment Term.
(a) Premium
Payment Term of Policies: Irrespective of the policy term, all individual
linked products, shall have the minimum features as stated below:
(i) Except
for single premium payment products, no product shall have a minimum premium
payment term (PPT) of 5 years.
(ii) Insurers
may design products which offer a range of premium paying terms and policy
terms within a product.
(iii) Insurers
may extend an option to a policyholder to alter the premium payment term or
policy terms provided that such alteration is in accordance with their Board
approved underwriting policy.
Regulation 9. Commissions or remuneration in any form.
(a) Commission
or remuneration in any form for the procurement of all individual policies in
respect of all the Distribution Channels except the Direct Marketing shall not
exceed the following:
(i) Other
than Pension Products:
(1) In case
of single premium, 2% of the single premium;
(2) In case
of other than single premium, the Table 9 (a) shall apply.
Table 9 (a)
1st year
|
Premium paying terms
|
Maximum Commission or
remuneration in any form as % of premium
|
|
2 & 3 year
|
Subsequent years
|
|
|
5
|
15
|
7.5/5(*)
|
5
|
|
6
|
18
|
7.5/5(*)
|
5
|
|
7
|
21
|
7.5/5(*)
|
5
|
|
8
|
24
|
7.5/5(*)
|
5
|
|
9
|
27
|
7.5/5(*)
|
5
|
|
10
|
30
|
7.5/5(*)
|
5
|
|
11
|
33/30(*)
|
7.5/5(*)
|
5
|
|
12 years or more
|
35/30(*)
|
7.5/5(*)
|
5
|
Note
- (*) The maximum commission or remuneration:
(a) For
brokers shall be:
(i) 30% in
the first year for policies with premium paying term 10 and above; and
(ii) 5% in the
subsequent years for all premium paying terms.
(b) During
the first ten years of a life insurer's business for all intermediaries, except
for brokers, shall be 40% in the first year for policies with premium paying
term 12 and above.
(ii) Pension
Products:
(1) In case
of single premium, 2 per cent of single premium.
(2) In case
of other than single premium:
(a) 71/2 per
cent of the first year's premium, and.
(b) 2% per
cent of each renewal premium.
(c) For all
distribution channels, except direct marketing, the maximum commission or
remuneration in any form with respect to fund based group products as
stipulated in Regulation 41 (a) herein, with respect to all premium payment
modes, shall be:
(i) 2 per
cent of the premiums paid during the year with a ceiling of rupees one lakh per
scheme for the entire year.
(ii) At
subsequent renewal, 2 per cent of the premiums paid during the year with a
ceiling of rupees one lakh per scheme for the entire year.
(d) If the
commission or remuneration in any form offered in a product is substantially
different between the distribution channels, the AA shall justify.
(i) The
reasons for the difference;
(ii) How the
difference is allowed in the pricing (i.e. charging structure) along with the
volumes projected for each distribution channel;
(e) Provided
where the policies are procured by Direct marketing, no commission shall be
payable.
CHAPTER-V Discontinuance Terms
Regulation 10. Grace Period.
The grace
period for payment of the premium for all types of linked insurance policies,
except single premium policies shall be:
(a) Fifteen
days, where the policyholder pays the premium on a monthly basis;
(b) Thirty
days, in all other cases.
Regulation 11. Lock-in Period.
All
linked insurance products shall have a lock-in period of five years from the
date of inception of the policy.
Regulation 12. Options of a policyholder upon discontinuance of the policy during the first five years.
(a) For other
than single premium policies, a policyholder shall be entitled to exercise one
of the following options upon the discontinuance of the policy:
(i) Revive
the policy within a period of two years, or
(ii) Complete
withdrawal from the policy without any risk cover.
(b) For
single premium policies, the policyholder shall be entitled to exercise the
option stipulated in sub-regulation a (ii) above.
Regulation 13. Obligations of an Insurer upon discontinuance of a policy before lock-in-period.
(a) Where a
policy is discontinued, the insurer shall take the following steps to enable
the policyholder to exercise the option as stipulated in Regulation 12 herein:
(i) Send a
notice within a period of fifteen days from the date of expiry of grace period
to such a policyholder to exercise the said options within a period of thirty
days of receipt of such notice:
Provided
that where the policyholder does not exercise the option within the notice
period of thirty days, the treatment of such policy shall be subject to
provisions stipulated in Regulation 15 herein.
Explanation.
The fund value/policy account value of the policy shall be part of the
segregated fund chosen/total policy account till the policyholder exercises
his/her option or tilt the expiry of thirty days of notice period whichever is
earlier. During this period the policy is deemed to be in force with risk cover
as per terms and conditions of the policy.
(ii) To impose
discontinuance charges only to recoup expenses incurred towards procurement,
administration of the policy and incidental thereto;
(iii) To design
the discontinuance charges to encourage the policyholder to continue with the
contract for the full term;
(iv) To ensure
that the discontinuance charges reflect the actual expenses incurred;
(v) To
structure the discontinuance charges within the statutory ceilings on
commissions and expenses; and
(vi) To ensure
that the charges levied on the date of discontinuance (as a percentage of one
annualized premium or a percentage of single premium) do not exceed the limits
specified below:
(1) For
annual premiums:
|
Where the policy is
discontinued during the policy year
|
Maximum Discontinuance
Charges for the policies having annualized premium up to Rs. 25,000/-
|
Maximum Discontinuance
Charges for the policies having annualized premium above Rs. 25,000/-
|
|
1
|
Lower of 20% * (AP or
FV/policy account value) subject to a maximum of Rs. 3000
|
Lower of 6% * (AP or
FV/policy account value) subject to a maximum of Rs. 6000
|
|
2
|
Lower of 15% * (AP or
FV/policy account value) subject to a maximum of Rs. 2000
|
Lower of 4% * (AP or
FV/policy account value) subject to a maximum of Rs. 5000
|
|
3
|
Lower of 10% * (AP or
FV/policy account value) subject to a maximum of Rs. 1500
|
Lower of 3% * (AP or
FV/policy account value) subject to a maximum of Rs. 4000
|
|
4
|
Lower of 5% * (AP or
|
Lower of 2% * (AP or
FV/policy
|
|
|
FV/policy account value)
subject to a maximum of Rs. 1000
|
account value) subject to
a maximum of Rs. 2000
|
|
5 and onwards
|
Nil
|
Nil
|
(2) For
Single premium policies:
|
Where the policy Is
discontinued during the policy year
|
Maximum Discontinuance
Charges for the policies having Single Premium up to Rs. 25,000/-
|
Maximum Discontinuance
Charges for the policies having Single Premium above Rs. 25,000/-
|
|
1
|
Lower of 2% *(SP or
FV/policy account value) subject to a maximum of Rs. 3000/-
|
Lower of 1% *(SP or
FV/policy account value) subject to a maximum of Rs. 6000/-
|
|
2
|
Lower of 1.5% *(SP or
FV/policy account value) subject to a maximum of Rs. 2000/-
|
Lower of 0.5%*(SP or
FV/policy account value) subject to a maximum of Rs. 5000/-
|
|
3
|
Lower of 1% *(SP or
FV/policy account value) subject to a maximum of Rs. 1500/-
|
Lower of 0.25%*(SP or
FV/policy account value) subject to a maximum of Rs. 4000/-
|
|
4
|
Lower of 0.5% *(SP or
FV/policy account value) subject to a maximum of Rs. 1000/-
|
Lower of 0.1%*(SP or
FV/policy account value) subject to a maximum of Rs. 2000/-
|
|
5 and onwards
|
Nil
|
Nil
|
AP-
Annualised Premium
SP-
Single Premium
FV- Fund
Value
(b) Provided
that where a policy is discontinued, only discontinuance charge and Fund
management charge, which shall not exceed 50 bps per annum on discontinuance
fund/policy account value, as applicable, may be levied by the insurer and no
other charges by whatsoever name shall be levied.
(c) Provided
that no discontinuance charges shall be imposed on top-ups premiums.
Regulation 14. Obligations of an insurer on revival of a discontinued policy.
(a) Where the
policyholder exercises the option to revive the policy, the policy shall be
revived restoring the risk cover along with the investments made in the
segregated funds as chosen by the policyholder, out of the discontinued
fund/policy account value, less the applicable charges as in sub-Regulation (b)
in accordance with the terms and conditions of the policy.
(b) The
insurer, at the time of revival:
(i) shall
collect all due and unpaid premiums without charging any interest or fee.
(ii) may levy
policy administration charge and premium allocation charge as applicable during
the discontinuance period. No other charges shall be levied.
(iii) Shall add
back to the fund, the discontinuance charges deducted at the time of
discontinuance of the policy.
Regulation 15. Obligations of the insurer upon surrender of the policy.
(a) Where the
policyholder exercises the option stipulated in sub-Regulation (ii) of
Regulation 12 (a) herein or does not exercise the option available in terms of
the proviso to sub-Regulation (i) of Regulation 13 (a), the fund value/policy
account value of the policy shall be credited to the discontinued policy
fund/policy account value. The proceeds of the discontinued policy shall be
refunded only upon completion of the lock-in period. The income earned on such
fund/policy account value shall be apportioned to the discontinued policy
fund/discontinued policy account value and shall not be made available to the
shareholders.
(b) The
insurer shall refund the amount by means of a cheque or demand draft, to be
delivered to the insured, at his last known address or through any other
electronic mode of payment to the specific bank account of the insured.
However, the insurer may deduct discontinuance charges on the date of
discontinuance on such policies, which shall not exceed the charges stipulated
in sub-Regulation (vi) of Regulation 13 (a) herein:
Provided
that in case of linked pension products, the insurer shall not refund more than
one-third of the proceeds of the discontinued policy or as per the extant income
tax provisions while the remaining amount shall be used to purchase an annuity
with the same insurer, subject to the provisions of section 4 of the Act.
Explanation:
(i) "Proceeds of the discontinued policies" means the fund
value/policy account value as on the date the policy has discontinued, after
addition of interest computed at the interest rate stipulated in Regulation 19
herein.
Regulation 16. Obligations of the insurer, where the insured or the nominee is not traced.
Where the
insured or his nominee, as applicable cannot be traced, the said proceeds shall
be set aside and shown separately in the annual report of the insurer with its
age wise break-up. The insurer shall not write back or apportion the said
proceeds to the income of the shareholders or to that of any other
policyholder. The proceeds so set aside shall be dealt with in such manner as
may be specified by the Authority from time to time. A separate statement shall
be furnished to the Authority on a half-yearly basis as stipulated in
Regulation 62(b) herein.
Regulation 17. Obligations of the insurer where two year revival period is not completed at the end of the lock-in period.
(a) For
policies which have not completed two years of revival period at the end of the
lock-in-period, the insurer shall take the following steps to enable the
policyholder to exercise the options available at the end of lock-in-period.
(i) Where a
policy is discontinued, the insurer shall take the following steps to enable
the policyholder to exercise the options:
(1) as
stipulated in Regulation 12 herein or
(2) Payout
the proceeds at the end of the lock-in-period or revival period whichever is
later.
(ii) Send a
notice within a period of fifteen days from the date of expiry of grace period
to such a policyholder to exercise the said options within a period of thirty
days of receipt of such notice:
Provided
that where the policyholder does not exercise the option within the notice
period of thirty days, the treatment of such policy shall be subject to
provisions stipulated in Regulation 15 herein.
Explanation.
The fund value/policy account value of the policy shall be part of the
segregated fund chosen/total policy account till the policyholder exercises
his/her option or till the expiry of thirty days of notice period whichever is
earlier. During this period the policy is deemed to be in force with risk cover
as per terms and conditions of the policy.
(b) If
sub-regulation a (i) of Regulation 12 or a(i)(2) above is opted, the fund shall
continue to remain in the discontinued policy fund/policy account value till
the policy is revived or up to the end of the revival period whichever is
earlier. If the policy is not revived within two years of the revival period,
the proceeds of the discontinued policy fund/discontinued policy account value
shall be paid out to the policyholder in accordance with Regulation 15.
Regulation 18. Segregated Discontinued Policy Fund/Discontinued policy account.
(a) Each
insurer shall have one discontinued policy fund/discontinued policy account for
all the pension products, one for all life insurance products and one for all
health insurance products. Each of these funds/policy accounts shall comprise
of all the discontinued policy funds/discontinued policy account values of all
the policies offered under the respective linked insurance products.
(b) In case
of unit linked products, the discontinued policy fund shall be a unit fund with
the following asset categories:
(i) Money
market instruments: 0% to 40%;
(ii) Government
securities: 60% to 100%.
Regulation 19. Minimum Guaranteed Interest Rate.
(a) The
minimum guaranteed interest rate applicable to the discontinued
fund/discontinued policy account shall be at an interest rate of 4 per cent per
annum.
(b) The
excess income earned in the discontinued fund/discontinued policy account over
and above the minimum guaranteed interest rate shall also be apportioned to the
discontinued policy fund/discontinued policy account value in arriving at the
proceeds of the discontinued policies and shall not be made available to the
shareholders.
Regulation 20. Obligations of the insurer in case of discontinuance of policy after the lock-in-period.
(a) In case
of discontinuance of policy after the lock-in-period, the insurer shall offer a
revival period of two years from the date of discontinuance of premium. During
this period the policy is deemed to be in force with risk cover as per terms
and conditions of the policy.
(i) Where a
policy is discontinued, the insurer shall take the following steps to enable
the policyholder to exercise the options:
(1) Revive
the policy within a period of two years, or
(2) Complete
withdrawal from the policy without any risk cover.
(3) Convert
the policy into paid-up policy, with the paid-up sum assured in accordance with
Section 113 (2) of the Insurance Act, 1938 i.e. sum assured multiplied by the
total number of premiums paid to the original number of premiums payable as per
the terms and conditions of the policy.
(ii) Send a
notice within a period of fifteen days from the date of expiry of grace period
to such a policyholder to exercise the said options within a period of thirty
days of receipt of such notice:
Provided
that where the policyholder does not exercise the option within the notice
period of thirty days, the treatment of such policy shall be, by default, in
accordance with (2) above.
Explanation.-The
fund value/policy account value of the policy shall be part of the segregated
fund chosen/total policy account till the policyholder exercises his/her option
or till the expiry of thirty days of notice period whichever is earlier. During
this period the policy is deemed to be in force with risk cover as per terms
and conditions of the policy.
CHAPTER-VI
Free Look Period, Surrender Value, Top-up Premium, Partial
Withdrawals and Settlement Options
Regulation 21. Return of Policy during the Free-look period.
(a)
In case of unit linked products, the policyholder shall be
entitled to an amount which shall at least be equal to non-allocated premium
plus charges levied by cancellation of units plus fund value at the date of
cancellation less expenses in accordance with the IRDA (Protection Of
Policyholders' Interests) Regulations 2000, if the policyholder returns the
policy.
(b)
In case of variable insurance products, the policyholder shall be
entitled to an amount in accordance with the IRDA (Protection Of Policyholders'
Interests) Regulations 2000, if the policyholder returns the policy.
Regulation 22. Surrender Value.
(a)
Surrender Value: All individual linked insurance and pension
products shall acquire surrender value in the following manner:
(i)
Linked Products other than linked pension products shall acquire
surrender value stipulated in Regulations 15 herein.
(ii)
Linked Pension Products shall acquire surrender value stipulated
in Regulation 27 herein.
(b)
Where a linked insurance product acquires a surrender value during
the first five years, it shall become payable only after the completion of the
lock-in-period. After the lock-in period, the surrender value shall be at least
equal to the fund value/policy account value as on the date of surrender.
(c)
The "Surrender Value" or the "surrender value
formula" shall be published in the policy document and all other
promotional materials of the policy.
Regulation 23. Top-up Premium.
(a)
A top-up premium is an amount of premium that is paid by the
policyholders at irregular intervals besides basic regular premium payments
specified in the contract and is treated as single premium for all purposes.
(b)
Top-up premiums can be remitted to the insurer during the period
of contract only, where due basic regular premiums are paid up to date and if
expressly allowed in the terms and conditions of the policy.
(c)
All top-up premiums made during the currency of the contract,
except for pension products, shall have insurance cover treating them as single
premium, as per the table 5.c.
(d)
Top-up premiums once paid cannot be withdrawn from the fund/policy
account value for a period of 5 years from the date of payment of the 'Top-up'
premium, except in case of complete surrender of the policy.
(e)
Except for pension products, top-up premiums are not permitted
during the last 5 years of the contract.
(f)
For pension products, top-up premiums may be allowed unlimitedly,
subject to providing the assured benefits on each of the top-up premiums paid.
(g)
For all other products other than pension products, at any point
of time during the currency of the contract, the total top-up premiums paid
shall not exceed the sum total of the regular premiums paid at that point of
time/single premium paid.
(h)
The minimum sum assured on top-up premium shall be based on the
age at payment of top-up premium but not on entry age.
Regulation 24. Partial Withdrawals.
(a)
Partial withdrawal shall be allowed only after fifth policy
anniversary.
(b)
in the case of child policies, partial withdrawals shall not be
allowed until the minor life insured attains majority i.e. on or after
attainment of age 18.
(c)
No partial withdrawal shall be allowed in case of
(i)
Linked pension products
(ii)
Fund based Group linked products.
(d)
Partial withdrawals made shall be allowed from the fund/policy
account value built up on from the top-up premiums, if any, as long as such
fund/policy account value supports the partial withdrawal and subsequently, the
partial withdrawals may be allowed from the fund/policy account value built up
from the base premium. The insurer shall have the necessary systems built to
identify the funds/policy account values from the base premiums and
funds/policy account values from top-up premiums.
(e)
The partial withdrawals with respect to the funds/policy account
values from the base premiums shall only be counted for the purpose of
adjusting the sum assured to be payable on death for the purposes of
sub-Regulation 5 (f)(i) herein. Partial withdrawals made from the top-up
premiums shall not be deducted for this purpose.
(f)
The partial withdrawals shall not be allowed which would result in
termination of a contract.
Regulation 25. Settlement Options under unit linked products.
(a)
The insurer may provide settlement options at the maturity
providing only periodical payments, In the contract so as to avoid the possibility
of fluctuations affecting the maturity value under linked life insurance
products and linked health insurance products.
(b)
Settlement options shall dearly indicate in the promotional
material, the inherent risk being borne by the policyholder during the period
and shall be explicitly understood by the policyholder.
(c)
The period of settlement shall not, in any case, be extended
beyond a period of five years from the date of maturity.
(d)
The insurer may levy fund management charge during the settlement
period and no other charges shall be levied.
(e)
Partial withdrawals and switches shall not be allowed during the
settlement period.
(f)
Complete withdrawal may be allowed at any time during the
settlement period without levying any charge.
(g)
The provisions of this Regulation shall not apply to linked
pension products and alt variable insurance products.
CHAPTER
VII Pension Products
Regulation 26. General Provisions with respect to Pension and annuity products.
(a)
Pension products may be offered on any of the following platforms:
(i)
Individual linked pension products;
(ii)
Fund based Group linked pension products;
(b)
Defined Assured Benefits:
(i)
All individual pension products shall have explicitly defined
assured benefit that is payable on:
(1)
Death and;
(2)
Vesting.
(ii)
The defined assured benefit shall be disclosed at the time of
sale.
(iii)
The assured benefit shall be utilized on the vesting date or on
date of death stipulated in sub-Regulations 28 and 29 herein, as applicable.
(c)
Pension products offered by the insurers may have a sum assured
payable on death throughout the deferment period or may offer riders. The sum
of all the rider premiums attached to the pension product shall not exceed 15%
of the premium paid for the pension policy. Such rider premiums shall be
separately accounted for and shall not be included in arriving at the assured
benefit as referred stipulated in Regulation (b) above.
Regulation 27. Surrender Value and Options on Surrender.
(a)
On the date of surrender during the lock-in-period, the provisions
stipulated in Regulation 15 herein shall be applicable. For the individual
linked pension products, the extant Income Tax Rules shall be complied with at
the time of closure of the contract at the end of the tock-in-period.
(b)
On the date of surrender after the lock-in period, the surrender
value shall not be less than the fund value/policy account value as on the date
of such surrender and the policyholder shall exercise one of the following
options:
(i)
To commute to the extent allowed under Income Tax Act and to
utilize the balance amount to purchase immediate annuity from the same insurer,
which shall be guaranteed for life, at the then prevailing annuity/pension
rate, or
(ii)
To utilize the entire proceeds to purchase the single premium
deferred pension product from the same insurer.
Regulation 28. Options on Vesting: On the date of vesting, the policyholder shall exercise one of the following options.
(i)
To commute to the extent allowed under Income Tax Act and to
utilize the balance amount to purchase immediate annuity with the same insurer,
which shall be guaranteed for life, at the then prevailing annuity/pension
rate, or
(ii)
To utilize the entire proceeds to purchase the single premium
deferred pension product with the same insurer; or
(iii)
To extend the accumulation period/deferment period within the same
policy with the same terms and conditions as the original policy provided the
policyholder is below an age of 55 years.
Regulation 29. Options to the Nominee on death of the policyholder.
If the policyholder dies during
the deferment period, the nominee shall exercise one of the following options:
(a)
To utilize the entire proceeds of the policy or part thereof for
purchasing an annuity at the then prevailing rate from the same insurer; or
(b)
Withdraw the entire proceeds of the policy;
Regulation 30. Financial Planning.
For the purpose of financial
planning, any pension product offered by the insurer shall comply with the
sales literature guidelines, issued by the life insurance Council circular
number LC/SP/Ver. 1.0 dated 3rd February, 2004 and shall also necessarily
disclose:
(a)
An illustrative target purchase price for each policyholder
considering the premium payment capacity, age, vesting age and the future
expected conditions.
(b)
Possible risks involved, if any, including the targeted pension
rate in meeting the targeted purchase price.
(c)
Possible risks involved, if any, in purchasing the targeted
pension rate/annuity rate.
(d)
An illustrative target annuity/pension rates for the illustrative
target purchase price.
(e)
For the purpose of providing benefit illustration, in addition to
the benefit illustration requirement stipulated in Regulation 40 herein,
additional benefit illustration shall be disclosed to the prospective
policyholder as in Annexure II.
Regulation 31. In addition to the regular yearly statement to be sent to the policyholder in accordance with Regulation 60 (d) herein, a yearly disclosure shall be sent to each policyholder in Annexure-III, on 1st April indicating.
(a)
The current accumulated/available amount;
(b)
The expected accumulated/available amount on the date of vesting
on the basis of the then prevailing and the likely assumed economic &
demographic environment, as relevant with the caveat, that the projected rates
shall not reflect any guarantee;
(c)
Likely annuity amounts based on the then prevailing annuity rates
and on assumed interest rates of 4% p.a. and 8% p.a. with the caveat, that the
projected rates shall not reflect any guarantee;
Regulation 32. Fund Based Groups Linked Pension Products.
(a)
For all fund based group linked pension products with the defined
benefits subscribed to by an employer, where the scheme does not maintain
individual member accounts and only maintains a superannuation fund:
(i)
There shall be an assured benefit that shall be applicable on the
entire superannuation fund available with the insurer.
(ii)
For exits such as death/retirement etc which are in accordance
with the scheme rules as agreed at the inception of the contract with group
policyholder, the insurer shall make payments from such funds only subject to
the availability of funds in the respective unit fund or policy account value
of the respective group policyholder's superannuation fund.
(iii)
Except for exits as per the scheme rules, no other withdrawals
shall be allowed.
(b)
For all fund based group linked pension products with the defined
contributions subscribed to by an employer, where the scheme maintain
individual member accounts:
(i)
There shall be an assured benefit that shall be applicable on each
of such individual accounts.
(ii)
For exits such as death/retirement/termination etc which are in
accordance with the scheme rules as agreed at the inception of the contract
with group policyholder, the insurer shall make payments from such individual
member funds only subject to the availability of funds in the respective unit
fund or policy account value of the respective member of the group
policyholder's.
(iii)
Except for exits as per the scheme rules, no other withdrawals
shall be allowed.
(c)
Provisions stipulated in Regulations 27, 28 and 29 herein shall
not be applicable to fund based group linked pension products; however the
benefits shall be subject to the scheme rules.
(d)
Provisions stipulated in Regulation 41 (e) herein shall apply in
case of complete surrender of the policy.
(e)
Where the group policyholder maintains superannuation funds with
more than one insurer, the group, policyholder shall have the option to choose
the insurer to purchase the immediate annuity.
Regulation 33. For the purpose of this Regulation.
(a)
Target purchase price shall mean an absolute amount guaranteed at
the outset of the contract or the accumulated value of the
premiums/contributions accumulating at an illustrative rate of 4% p.a. and 8%
p.a., which is expected to meet the policyholder's pension needs after allowing
for commutation.
(b)
Targeted pension rate shall mean the pension that a policyholder
expects to receive at the date of vesting at an illustrative assumed rate of
interest of 4% p.a. and 8% p.a. allowed in pricing the annuity
(c)
"Guaranteed for life" shall mean:
(i)
an amount of annuity is guaranteed, in absolute terms, at the time
of vesting or at the time of surrender or at the time of sale and
(ii)
Such guaranteed amount shall become payable as long as the
policyholder survives.
(d)
An assured benefit means at least one of the guarantees from the
following options of providing either:
(1)
non-zero positive rate of return on the premiums paid, excluding
service tax, from the date of payment to date of vesting or
(2)
an absolute amount to be paid on death or maturity (which shall
result in non-zero positive return).
(3)
In both the above cases, the amount of such guarantee shall be
disclosed at the time of purchase of contract.
(4)
The non-zero positive return on death may be more than the
non-zero positive return on maturity/vesting.
(5)
A guaranteed maturity benefit (in absolute amounts) which shall be
utilized at the vesting date or guaranteed death benefit (in absolute amounts)
payable on death shall be disclosed at the time of purchase of contract.
(e)
The prevailing annuity rate shall mean the annuity rates that are
approved by the authority as per the file and use procedure and are attached to
the pension products.
(f)
Commutation shall mean the giving up of a part or all of the
annuity payable from vesting/surrender for an Immediate lump sum:
CHARTER-VIII Charges A Reduction in
Yield for all Linked Products
Regulation 34. Charges.
(a) The life
insurers shall use uniform definitions for charges under all the linked
products in accordance with this regulation.
(b) The
Insurers shall distribute the overall charges, in all linked products, in an
even fashion during the lock-in period such that the:
(i) premium
allocation charge and policy administration charge shall be spread evenly
during first 5 years of the policy contract, without wide fluctuations;
(ii) charges
could change from year to year in a reasonably orderly manner so that the
difference between the maximum and minimum charges during first 5 years shall
not vary by more than 1.5 times.
(c) For the
purpose of this Regulation, the unit fund shall be read as the policy account,
in case of variable insurance products and the charges shall be levied to the
policy account, wherever applicable.
Regulation 35. The charges levied under the linked insurance products shall be.
(a) Premium
Allocation Charge: This is a percentage of the premium appropriated towards
charges from the premium received. For unit linked products, the balance amount
known as allocation rate constitutes that part of premium which is utilized to
purchase the units of the fund in the policy. For variable insurance products,
the balance amount shall be credited to the policy account. The percentage
shall be explicitly stated and could vary by the policy year in which the
premium is paid, the premium size and the premium type (regular, single or
top-up premium).
(i) This is a
charge levied at the time of receipt of premium.
(ii) Example:
If premium = Rs. 1000 & Premium Allocation Charge: 10% of the premium; then
the charge: Rs. 100 and Balance amount of premium is Rs. 900.
(b) Fund
Management Charge (FMC):
(i) For unit
linked products, this is a charge levied as a percentage of the value of assets
and shall be appropriated by adjusting the Net Asset Value. This is a charge
levied at the time of computation of NAV, which is usually done on daily basis
(ii) For
variable insurance products, this is a charge levied as a percentage of the
policy account value and shall be appropriated to the policy account value.
(iii) Example:
If Fund Management charge (FMC) is 1% p.a. payable annually; Fund before FMC is
Rs. 100/- and Fund after this charge is Rs. 99/-.
(c) Guarantee
Charge:
(i) For unit
linked products, this is a charge levied as a percentage of the value of assets
and shall be appropriated by adjusting the Net Asset Value.
(ii) This is a
charge levied at the time of computation of NAV, which is usually done on daily
basis.
(iii) In case
of variable insurance products, the insurer shall not levy any guarantee
charge.
(d) Policy
Administration Charge: This charge shall represent the expenses other than
those covered by premium allocation charges and the fund management expenses.
This is a charge which may be expressed as a fixed amount or a percentage of
the premium or a percentage of sum assured.
(i) For unit
fund, this charge is levied at the beginning of each policy month from the unit
fund by canceling units for equivalent amount.
(ii) For
variable insurance products, this charge is levied at the beginning of each
policy month from the policy account value.
(iii) This
charge could be flat throughout the policy term or vary at a pre-determined
rate, subject to an upper limit. The pre-determined rate shall preferably be
say an x% per annum, where x shall not exceed 5.
(iv) Example:
Rs. 40/- per month increased by 2% p.a. on every policy anniversary.
(e) Surrender
Charge or Discontinuance charge
(i) This is a
charge levied on the unit fund/policy account value where the policyholder opts
for complete withdrawal of the contract as stipulated in Regulation 12 a (ii)
herein.
(ii) This
charge is usually expressed either as a percentage of the fund or as a
percentage of the annualized premiums (for regular premium contracts).
(f) Switching
Charge: For unit linked products, this is a charge levied on switching of
monies from one fund to another available within the product. The charge per
each switch, if any, shall be levied at the time of effecting the switch and it
shall be either a flat amount or lower of {a flat amount or percentage of the
fund value}.
(g) Mortality/Morbidity
charge: This is the cost of life/health insurance cover. It is exclusive of any
expense loadings levied by cancellation of units. This charge, if any, shall be
levied at the beginning of each policy month from the fund.
(i) The
method of computation shall be explicitly specified in the policy document. The
mortality/morbidity charge table shall form part of the policy document.
(ii) Mortality/morbidity
charge table shall be guaranteed during the contract period.
(iii) The
mortality/morbidity charge for the mortality/morbidity risk covered shall:
(1) only
reflect the pure risk charges for the cover offered and shall not include any
allowance for expenses or any other parameters.
(2) be
reasonable and consistent with the prescribed mortality tables or morbidity
tables, if any.
(3) be
demonstrated with the support of insurer's own experience, wherever applicable.
(4) be
expressed as per Rs. 1000 Sum at risk for each age.
(h) Rider
charge: This is the rider charge which is exclusive of expense loadings and
levied separately to cover the cost of rider cover. The rider charge, if any,
shall be levied by cancellation of units. This charge is levied at the
beginning of each policy month from the fund.
(i) The rider
charge table shall be form part of the policy document.
(ii) The rider
charge shall:
(1) only
reflect the pure risk charges for the cover offered and shall not include any
allowance for expenses or any other parameters.
(2) be
reasonable and consistent with the prescribed mortality/morbidity tables
(3) be
demonstrated with the support of insurer's own experience, wherever applicable.
(4) be
expressed as per Rs. 1000 Sum Assured for each age
(iii) Only
linked riders approved by the Authority shall be attached to linked products.
(i) Partial
withdrawal charge: For unit linked products, this is a charge levied on the
unit fund at the time of part withdrawal of the fund during the contract
period.
(j) Miscellaneous
charge:
(i) This is a
charge levied for any alterations within the contract, such as, increase in sum
assured, premium redirection, change in policy term etc. The charge is
expressed as a flat amount. For unit linked products, this shall be levied by
cancellation of units.
(ii) This
charge is levied only at the time of alteration.
(iii) Example: Rs.
100/- for any alteration such as increase in sum assured, change in premium
mode etc.
Regulation 36. Other conditions on Charges.
(a) The
charges as filed under the File and Use and approved by the IRDA shall not be
modified or changed without obtaining the prior approval of the IRDA.
(b) All the
charges other than premium allocation charge and mortality charge shall have an
upper limit, if any, specified in all the promotional material and policy
document.
(c) All the
charges, where upper limit is allowed, may be modified with supporting data
within the upper limits with prior clearance from the Authority.
(d) The cap
on Fund Management Charges in respect of each of the segregated fund shall be
135 basis points and cap on guarantee charge shall be 50 basis points.
Regulation 37. Difference between Gross Yield and Net Yield for all linked products.
(a) Subject
to sub-regulation (b), the maximum reduction in yield for policies from the
fifth policy anniversary shall be in accordance with the Table 37 a.
Table: 37 a.
|
Number of years elapsed
since inception
|
Maximum Reduction in
Yield (Difference between Gross and Net Yield (% p.a.))
|
|
5
|
4.00%
|
|
6
|
3.75%
|
|
7
|
3.50%
|
|
8
|
3.30%
|
|
9
|
3.15%
|
|
10
|
3.00%
|
|
11 and 12
|
2.75%
|
|
13 and 14
|
2.50%
|
|
15 and thereafter
|
2.25%
|
(b) The net
reduction in yield at maturity for policies with term:
(i) less than
or equal to 10 years shall not be more than 3.00% and
(ii) above 10
years shall not be more than 2.25%.
(c) The
insurer shall ensure that the reduction in yield in (a) and (b) is complied for
all gross investment returns. However, only for the purpose of demonstration,
the insurer shall demonstrate in the File and Use Application the compliance
reduction in yield in (a) and (b) for gross investment returns of 6% p.a., 8%,
10% p.a. 15% p.a., 20% p.a., 25% p.a.
(d) In the process
to comply the reduction in yield, the insurer may arrive at specific
non-negative additions, if any, to be added to the unit fund/policy account
value, as applicable, at various durations of time. In case of unit linked
products, such specific non-negative additions shall be called non-negative
draw-back additions and shall be filed in the file and use procedure for
approval.
Regulation 38.
At the
time of Maturity, the insurer shall issue the policyholder a certificate
showing year-wise contributions, charges deducted, fund value and final payment
made to the policyholder taking into account partial withdrawals, if any. This
certificate shall confirm adherence of above prescription.
Regulation 39. Computation of Net Yield.
(a) Mortality
and Morbidity charges may be excluded in the calculation of the net yield.
(b) Extra
premium due to underwriting emanating from extraordinary health conditions,
cost of all rider benefits, service tax on charges (as applicable) and any
explicit cost of investment guarantee shall be excluded in the calculation of
net yield. The calculation of all charges shall be as per 'File and Use'
document as approved by the IRDA.
(c) The net
yield shall be calculated based on the projection of end found on monthly basis
at a specified gross rate of return assuming the mortality and morbidity
charges as zero throughout the term of the contract and premiums are paid as
and when due. The equation of value concerning the gross premium paid by the
policy holder and the maturity fund value shall give the effective net yield
per annum expected to be earned on the contract at the point of sale.
(d) As the
policyholder' behavior with regard to options under Linked products, for
example partial withdrawals, premium redirection etc. affect the met yield; such
options may be ignored throughout the term of the contract of demonstrating the
net yield.
(e) A sample
calculation of net yield is given in Annexure IV.
Regulation 40. Customized Benefit Illustration.
(a) The
benefit illustration shall be shown as per the gross investment returns
prescribed by the Life Insurance Council which are currently 4% and 8% and the
corresponding net yield shall be demonstrated only with respect to gross
investment return of 8% p.a.
(b) The
customized benefit illustration shall include all charges as applicable,
services tax and fund values including commission/brokerage payable.
(c) The net
yield and hence reduction in net yield as calculated, shall be disclose in the
benefit illustration indicating the corresponding gross yield figures.
(d) The
benefit illustration shall be as prescribed in Annexure V_A for Unit Linked
Products and V_B for Variable Linked Products.
CHAPTER-IX
Fund Based Group Linked Products
Regulation 41. Fund Based Group Linked Products.
(a)
Expect for fund based group linked products, no other group linked
product shall be offered under linked platform, where fund based group linked
products are those which are offered to Employer-Employee groups and consists
of:
(i)
Group Linked Superannuation Products;
(ii)
Group Linked Gratuity Product;
(iii)
Group Leave Encashment Product;
(b)
Provision stipulated in Regulations 5, 10 to 20, 23, 24 and 25
shall not be applicable to fund based group linked products. However, the group
linked policies in (a) (ii) & (a) (iii) above shall have life cover
depending on needs of group.
(c)
The premium with respect to group schemes shall be made in
accordance with the Actuary's certificate submitted by the employer in
accordance with the AS 15 (Revised). Where the fund is over funded/in surplus
as per such certificate, the insurer may allow "nil
contributions/premiums" under the policy and in all such cases, the policy
shall not be treated as discontinued.
(d)
The fund based group linked products shall not allow any top-ups,
unless required as per the actuary's certificated in accordance with the AS 15
(Revised), to address the under funding of the scheme.
(e)
The fund based group linked products. may levy a surrender charge
not exceeding 0.05 per cent of the fund/policy account value, with a maximum of
Rs. 500,000/-, if the policy is surrendered within the third renewal of the
policy.
(f)
Fund based group linked products may offer life insurance cover
with an explicit mortality charged levied.
(g)
Provisions stipulated in Regulation 34, 35, 36 and 37 herein shall
be applicable to fund based group linked products.
(i)
At each individual account level, if individual accounts are
maintained;
(ii)
At each policyholder fund level, if individual accounts are not
maintained and only one fund is maintained.
For the purpose of this
Regulation, "number of years elapsed since inception" stipulated in
Regulation 37 herein shall be read as "number of years elapsed since
renewal of the policy".
Regulation 42. Fund Based Group Linked Products Administration.
(a)
The premium charged and benefits admissible to each member of the
group shall be cleanly specified in the group policy and the group policyholder
shall not have the liberty to vary the premium or benefits with regard to the
individual members.
(b)
Groups discounts on premium are given for the benefit of the
insured members of the group and shall not be appropriated as additional
remuneration by the agent or corporate agent or broker or group policyholder.
Such discounts shall be based on valid underwriting considerations such as the
group size and shall be passed on to the members.
(c)
Where a part or whole of the premium is paid by the group
policyholder, for example, the employer in respect of insurance of his
employees, the discounts may be shared by those who paid the premium in
proportion to the premium paid by them.
(d)
There shall be no other payment whether as management expenses or
documentation expenses or profit commission or bulk discount or payment of any
other description, to the agent or corporate agent or group policyholder. The
group policyholder shall be specifically prohibited from collecting by way of
premium from the members of a group, any amount higher than the amount charged
by or paid to the insurer for such insurance.
(e)
The insurer, under an agreement with the group policyholder, may
leverage on the existing infrastructure, if any, for better administration of
the scheme with respect to the following services:
(i)
Data management Documenting the list of the persons insured under
the group policy from time to time and supporting the insurer with quality data
on all members of the scheme and Know Your Customer requirements. The data
management shall enable seamless transfer of data to insurer at regular
intervals of each month or at short intervals as decided between the insurer
and the group policyholder, to ensure efficient claims handling and
establishing accurate reserving and pricing.
(ii)
Collection of Premium Group policyholder may support the insurer
through prompt premium collections under contributory schemes and its
remittance to the insurer on a timely manner for better cash flow management.
(iii)
Issuance of Certificate of insurance The insurer shall be
responsible to issue certificate of insurance to each group member of the
policy where individual accounts are maintained. However, the insurer may
provide the facility to the group policyholder to issue certificates of
insurance to persons insured under the group, provided the underwriting
guidelines for acceptance or rejection of such a risk do not require use of
subjective judgment and can be easily programmed into a computer that will
review acceptance and print the certificate of insurance. The procedure to be
followed include:
(1)
The certificate shall contain information on the schedule of
benefits, the premium to be paid and important terms and conditions of the
insurance contract.
(2)
The certificate shall also state the procedure to be followed to
register a claim with the insurer including the full address of the office of
the insurer where the claim should be registered.
(3)
The certificate forms shall be supplied by the insurer with
in-built security features and in pre-numbered lots to the group policyholder.
Before furnishing a fresh lot of forms, insurer shall personally verify the
previous issue of certificate of insurers.
(4)
Under any circumstances the insurer shall be responsible for the
certificate of insurance issued by a group policyholder, in certificate forms
provided by the insurer.
(5)
The insurer shall be held responsible to the group members
insured, in respect of the group policy in case of failure of the group
policyholder to account for the business to the insurer, if the group member
insured can prove that he had paid the premium and secured a proper receipt
leading him to believe that he was duly insured.
(iv)
Claims settlement The insurer may take the services of the group
policyholder in facilitating the registering and settlement of a claim,
however, the insurer is totally responsible to ensure that the claim payment is
made in the name of the insured member, with respect to the life cover
available in the group linked products, even if the cheque is sent to the group
manager for administrative convenience. For other claim payments, the payment
shall be made in accordance with the scheme rules. This payment shall be made
only when the service is rendered.
(f)
The insurer may make payments directly to the group policyholder
for the services rendered as in (e) under an agreement. The Authority may
prescribe such remuneration to be paid to the Group Policyholder from time to
time for each of the services rendered as in (e) and the current limits shall
not be more than:
(i)
For data management: Rs. 15/- per member per annum;
(ii)
Premium collection: Rs. 10/- per member per annum;
(iii)
Issuance and delivery of certificate of Insurance: Rs. 10/- per
member subject to a minimum of Rs. 500/-. Issue of duplicate certificate of
insurance shall not be done by the group policyholder;
(iv)
Claims settlement: Rs. 10/- per claim;
(g)
If the business is procured through an intermediary, the
remuneration with respect to the functions referred in (e) (i), (ii) and (iv)
shall not be paid to the group policyholder, as these functions are part of
obligation of an of an intermediary. However, with respect to the services
referred in e (iii), the services of a group policyholder may utilized and
payment may be made as stipulated in f (iii).
(h)
If the business is procured directly, the remuneration with
respect to the functions referred in (e) (i) (ii) and (iv) may be paid to the
group policyholder, only if the group policyholder has provided all the
services in accordance with the agreement. The payments to the group
policyholder:
(i)
all put together shall not in any case exceed 20% of the
commission payable as stipulated in Regulation 9 herein in case of both Single
premium products and other than single premium products.
(ii)
shall ensure that for each of the services individually, the
payment shall not exceed the rated proportion to the overall limit of 20% of
the commission payable as stipulated in Regulation 9 herein in case of both
Single premium products and others than single premium products.
CHAPTER-X
Computation of Net Asset Value (NAV) for Unit Linked Products
Regulation 43. Computation of NAV.
(a)
The NAV of the Segregated FUND[SFN] shall be computed as:
Market value of investment held
by the fund + value of current assets (value of current liabilities and
provisions, if any)
Number of units on valuation Date
(before creation/redemption of units)
(b)
The NAV computed as above, in respect of 'each' Segregated Fund,
shall be Audited by the Concurrent Auditor on a day-to-day basis.
(c)
The NAV calculated as above, in respect of 'each' Segregated fund
shall be declared daily on the Insurer's Website and at the Life Insurance
Council's Website, as and when the same is ready.
(d)
The sale or purchase shall be on a meet basis.
Note:
(i)
Market value of investment, held by the fund.
(ii)
Value of Current Assets represents Accrued interest, Dividend
Receivable, Bank Balance, Receivable for Sale of Investments and Other Current
Assets (for Investment)
(iii)
Value of current liabilities represents Payable for Investments
(iv)
Number of units derived from the investment accounting system
shall be reconciled on a day to day basis with the policy administration system
(v)
Provisions shall include expenses for brokerage and transaction
cost, NPA, Fund Management Charges (FMC) and any other charges approved by
Authority.
Regulation 44. Segregated Funds.
(a)
Each Segregated Fund shall have:
(i)
A 'single' NAV, declared on a day-to-day basis and
(ii)
Fund management charge, if any, shall be specific to each
segregated fund.
(b)
Each segregated fund shall have identified assets representing the
investment of such segregated funds.
(c)
The Internal/Concurrent Auditor shall certify that such
segregation had not resulted in enrichment of one set of policyholders from
others due to change in the units or NAV.
(d)
The implication, to the policyholder of such change, if any, shall
be put on the insurer's website along with the rationale of making such change.
(e)
The concurrent Auditor shall confirm the insurer's adherence to
these requirements.
Regulation 45. Asset Allocation under each fund.
(a)
The asset allocation range for each asset category shall be separate
and explicitly stated.
(b)
Within a fund, no asset category shall have the asset allocation
of "0%-100%", if more than one asset category is represented in the
fund.
(c)
The asset allocation range shall reflect the investment objectives
of the underlying fund.
CHAPTER-XI
Administration of Linked Insurance Products
Regulation 46. Administration of Linked Insurance Products.
(a)
The insurers shall not launch any product, unless all the
processes are lay down and suitable infrastructure requirements on an ongoing
basis for the products to be launched are established and enable the insurer to
perform all the day-to-day operations, computation of NAV on a daily basis,
determination of the reserves and solvency margin from day of launch of such
products, and as required under the legislation, regulation etc.
(b)
Where policies may be credited with additional benefits during the
term of the contract or where the benefits are complexly designed and deviates
from the simple insurance product structured, the insurer shall demonstrate to
the Authority that it has established all the systems required to manage the
day to day operations of the portfolio and shall enable the Appointed Actuary
to determine the reserves and solvency margin calculations as required.
(c)
The Board or its delegated risk committee shall certify that
"all the system requirements on an ongoing basis for the product
................(product name) to be launched are established and the systems
enable the insurer from day of launch of the product, to perform seamlessly all
the day-to-day operations, computation of NAV on a daily basis and enables to
submit all the necessary reports and returns as required under the legislation,
regulation etc". The certificate shall be submitted before the launch of
the product.
(d)
With regard to the existing products, the insurer shall submit the
certificate to the Authority within 30 days from the date of this regulation.
CHAPTER-XII
Miscellaneous Provisions
Regulation 47. Level Premiums.
(a)
Except for group products, the premium chosen at the outset shall
become payable throughout the premium paying term of the policy and shall not
be altered during the term of the policy. Such premium shall be level/uniform
and shall not vary over the term of the policy.
(b)
The insurer shall not accept any amounts less than the due
stipulated regular premium payable as stated in the policy.
(c)
Any additional payments made on ad hoc basis shall be considered
as top-up premium and treated as single premium for the purpose of providing
insurance cover.
(d)
Service tax, if any, shall not be included in the contractual
premium and shall be collected from the policyholder separately as over and
above such premium.
Regulation 48. Allotment of Units under unit linked products.
(a)
Units shall only be allocated on the day the proposal is accepted
and results into a policy by adjustment of application money towards premium.
(b)
The premium shall be adjusted on the due date even if it has been
received in advance and the status of the premium received in advance shall be
communicated to the policyholder. This shall be disclosed in all
literatures/documents furnished to the policyholders.
Regulation 49. Loans.
(a)
Loans shall not be allowed under the Linked Insurance Products.
(b)
The promotion material shall display prominently in a bold font in
the front page that "the Linked Insurance Products do not offer any
liquidity during the first five years of the contract. The policyholder will
not be able to surrender/withdraw the monies invested in Linked Insurance
Products completely or partially till the end of the fifth year".
Regulation 50. Series/Tranche of Funds under unit linked products.
(a)
Products with "highest NAV guaranteed" shall not be
allowed.
(b)
Any guarantee offered in the benefits under a linked product shall
be at the product level and shall not be related to any of the underlying
funds.
(c)
The opening of series of closed ended funds shall not be allowed
within a product.
Regulation 51. Market Value adjustment.
(a)
Market value adjustment shall not be allowed under:
(i)
Individual products
(ii)
Non-par fund based group products where the product has no
investment guarantees.
(b)
Market value adjustment may be allowed for non-par fund based
Group products for bulk exits and complete surrender, where the bulk exits are
clearly defined in the contract and provided there is an investment guarantee
assured throughout the policy period.
(c)
Market value adjustment shall be defined explicitly &
objectively and approved under File and Use. There shall not be any discretion
left to the insurer in arriving at the market value adjustment.
(d)
Market value adjustment shall not be applicable for the amounts
below the amount which represents the bulk exits and shall be applied only to
the amount which is over and above the amount representing bulk exit.
(e)
For the purpose of this regulation:
(i)
If the amount to be paid on total exits in any event exceeds 25%
of the total fund of the scheme at the beginning of the year, such transactions
shall be treated as bulk exits, where exit shall be as per the scheme rules.
(ii)
"Exit" shall mean exit of the member from the group.
Regulation 52. Advance Premium.
[Advance
premium:
(i)
Collection of advance premium shall be allowed within the same
financial year for the premium due in that financial year. However, where the
premium due in one financial year is being collected in advance in earlier
financial year, insurers may collect the same for a maximum period of three
months in advance of the due date of the premium.
(ii)
The premium so collected in advance shall only be adjusted on the
due date of the premium.
(iii)
The commission shall only be paid after adjustment of premium on
due date.]
Regulation 53. Splitting of Policies.
(a)
Splitting of policies shall not result into any increase, directly
or indirectly to the policyholder by way of fees or charges in whatsoever name
at any time during the term of the policies and not just at the inception.
(b)
A policy will be deemed to be split, if multiple policies of the
same nature are sold to a prospect at the same time which results into a
situation defined in (a) above.
Regulation 54. Linked Health Insurance Products.
All the health insurance products
under linked platform shall comply with the extant regulations, guidelines and
circulars applicable for unit linked insurance products.
Regulation 55. Approval of Innovative products.
(a)
Innovative products can be defined as the products which are
uncommon in the market. Any product design, which is not approved so far by the
Authority, shall be treated as innovative product.
(b)
The innovativeness in product design shall result in meeting
customer needs, better customer understanding and satisfaction and shall not
result in complexity of understanding the product, additional strain on the
company's infrastructure, which may result in increased cost to the customer.
(c)
The insurer shall discuss with the Authority, the product design
concept of the proposed innovative product along with:
(i)
Market research inputs which identify the specific needs of
customer or meeting the existing needs in innovative manner through the
proposed product design.
(ii)
A separate note On how such new product will enhance the
satisfaction of customer and of any other stakeholder.
(iii)
Details on systems support that is being envisaged for execution
of the proposed product.
(iv)
Details on underwriting, claims settlement, investment strategies
for such new products.
(v)
Treatment for arriving at the reserves, solvency margin required
for such products.
(vi)
Market conduct requirements for such products.
(d)
Whether any such products are available elsewhere in other
markets. If available, the general structure of such products, the valuation
requirements, market conducts and specific regulations on such products.
Regulation 56. Financial Viability of the Products.
(a)
All the products once approved shall be reviewed by the Appointed
Actuary at least once a year on the financial viability of the product. If the
product is found to be financial unviable, the Appointed Actuary shall revise
the product under File and Use procedure. After 5 years of File and Use
approval, the Appointed Actuary shall re-file the product along with the past
five years experience in terms of mortality, lapse, interest rates, inflation,
expenses etc. and seek fresh approval with suitable justifications for the
assumptions made.
(b)
If the pricing assumptions for mortality is less than 50% of the
prescribed table, the Appointed Actuary shall justify such assumptions with the
actual claims experience for similar products for the past 3 years
CHAPTER-XIII
Market Conduct
Regulation 57. Market Conduct.
(a)
All Life Insurers shall give a periodical in house training to the
persons involved in soliciting or procuring the business
(agents/intermediaries) of their respective companies. A statement indicating
the number of agents trained shall be furnished to the Authority which shall be
appended to AAAR.
(b)
The Insurers shall impart this as a separate training to all the
insurance agents/intermediaries before they are authorized to sell linked
insurance products to ensure required expertise.
(c)
The curriculum for this in-house training should inter alia
contain;
(i)
the developments of the capital market,
(ii)
The basic knowledge of concept and working of the Linked Insurance
Products,
(iii)
Risks in investing in Linked Insurance Products with reference to
different funds,
(iv)
The developments in other similar type of financial products, the
concept of equity market, debt market and the overall economic scenario as
affecting the capital market in general and the features of the linked
products.
(v)
This shall be a separate training in addition to the mandatory
hours training for issuing and renewing the license respectively. The training
shall be on a continuous basis.
(d)
Every life insurer shall maintain a register of such persons
(agent/intermediaries), who have undergone this specific training. Insurers
need to make sure that their insurance advisors selling the linked life
insurance products render unbiased advice to enable the policyholders
recognizes whether the recommended product is suitable.
(e)
An agent/intermediary shall maintain the records pertaining to the
policyholder to demonstrate that sufficient information has been collected
about the potential policyholder to enable a suitable product to be
recommended. The agent/intermediary shall prepare a needs assessment form and
enclose it to the proposal giving his recommendations of the appropriateness of
the product recommended by him. This will form part of the policy file of the
individual. These records shall be made available to the Authority, whenever
called for.
(f)
Further, an agent/intermediary shall provide the sales illustration
statement as prescribed to the potential policyholder. He/she shall clearly
indicate how premium paid is appropriated towards various charges from the unit
fund and the balance of the fund at the end of the first year and subsequent
years. The upfront charges in the initial years have to be brought to the
knowledge of the policyholders.
(g)
An agent/intermediary shall obtain a statement of consent (to be
furnished along with the documents under F & U Procedure) signed by the
policyholder and countersigned by the person (agent, intermediary etc)
himself/herself, along with the proposal form, that he has understood the
inbuilt features of the policy and the applicable charges and that he is fully
aware of investment risks under the policy to be issued. A copy of the
illustration explained to the proponent duly countersigned by the
agent/intermediary and the proponent shall also form part of the proposal
papers.
(h)
An Insurer or its agent/intermediary shall not make any
exaggerated statement, whether oral or written, either about their
qualifications or capability to render investment management services or their
achievements.
(i)
Appropriate documentation forming part of the proposal papers to
demonstrate informed decision making on the part of the proponent in deciding a
particular insurance product.
(j)
Life insurance Council shall issue guidelines on:
(i)
"Code of conduct" to be followed by all the insurers and
the intermediaries selling linked products to ensure no mis-sale takes place.
(ii)
Uniform practice for rounding off the unit prices.
Regulation 58. Policyholder Education.
The insurers and life insurance
council shall actively promote education of the policyholders on the Linked
Products on an ongoing basis to guide them in taking appropriate decisions in
terms of the features, risk factors including the terminology and the
definitions of charges under these products.
Regulation 59. Uniform cut-off timings for applicability of Net Asset Value in case of unit linked products.
The allotment of units to the
policyholder shall be done only after the receipt of premium proceeds as stated
below:
(i)
Allocations (premium allocations, switch in):
(a)
In respect of premiums/funds switched received up to 3 p.m. by the
insurer along with a local cheque or a demand draft payable at par at the place
where the premium is received, the closing NAV of the day on which premium is
received shall be applicable.
(b)
In respect of premiums/funds switched received after 3 p.m. by the
insurer along with a local cheque or a demand draft payable at par at the place
where the premium is received, the closing NAV of the next business day shall
be applicable.
(c)
In respect of premiums received with outstation cheques/demand
drafts at the place where the premium is received, the closing NAV of the day
on which cheques/demand draft is credited shall be applicable.
(d)
Having regard to the above, insurer shall ensure that each and
every payment instrument is banked with utmost expedition at the first
opportunity, given the constraints of banking hours, prudently utilizing every
available banking facility (e.g. high value clearing, account transfer etc.)
Any loss in NAV incurred on account of delays, shall be made good by the
insurer.
(ii)
Redemptions:
(a)
In respect of valid applications received (e.g. surrender,
maturity claim, switch out etc) up to 3 p.m. by the insurer, the same day's
closing NAV shall be applicable.
(b)
In respect of valid applications received (e.g. surrender,
maturity claim, switch etc) after 3 p.m. by the insurer, the closing NAV of the
next business day shall be applicable.
CHAPTER-XIV
Disclosure Norms under
Regulation 60. Disclosure Norms.
(a)
For all unit linked products, all Life Insurers shall necessarily
and explicitly mention, using the same font size, in all the sales brochures,
prospectus of Insurance products, in all promotional material and in policy
documents:
(i)
On top of each document including the proposal form mention,
"In this policy, the investment risk in investment portfolio is borne by
the policyholder".
(ii)
The various funds offered along with the details and objective of
the fund.
(iii)
The minimum and maximum percentage of the Investments in different
types (like equities, debt etc.), investment strategy so as to enable the
policyholder to make an informed investment decision. "No statement of
opinion as to the performance of the fund shall be made anywhere."
(iv)
The definition of all applicable charges, method of appropriation
of these charges and the quantum of charges that are levied under the terms and
conditions of the policy,
(v)
The maximum limit up to which the insurer reserves the right to
increase the charges subject to prior clearance of the Authority.
(vi)
The fundamental attributes and the risk profile (low, medium or
high) of different types of investments that are offered under various funds of
each linked product.
(b)
For all unit linked products, the policyholder shall be given the
full details, using the same font, related to the investments, as an annual
report, covering the fund performance during the preceding financial year in
relation to the economic scenario, market developments etc. which should
including particulars like.
(i)
The investment strategies and Risk Control measures adopted.
(ii)
The changes in fundamentals, such as interest rates, tax rates,
etc., affecting the investment portfolio.
(iii)
The composition of the fund (debt, equity etc), analysis within
various classes of investment, investment portfolio details, sectoral exposure
of the underlying funds and the ratings of investments made.
(iv)
Analysis according to the duration of the investments held.
(v)
Performance of the various funds over different periods like 1
year, 2 years, 3 years, 4 years, 5 years and since inception along with
comparative benchmark index.
(c)
A copy of such annual report referred in (b) above shall be
appended to the Appointed Actuary Annual Report (AAAR) and shall be submitted
along with the AAAR.
(d)
All the Life Insurers are required to issue the periodical
statements of accounts to policyholders each year disclosing the actual charges
levied and the fund/policy account value at the beginning and end of the year.
(i)
Unit statement account/Policy account value shall form a part of
the policy document
(ii)
Unit statement account/Policy account value shall make a reference
to the terms and conditions applicable under the respective policy document.
(iii)
Unit statement account/Policy account value shall be issued on
every policy anniversary and also as and when a transaction takes place.
(e)
No unit statements/Policy account value shall be required to be
sent to the policyholder in respect of transactions related to monthly debit of
mortality and other charges specified in the contract.
(f)
All the insurers shall submit the disclosures relating to
discontinued policies as specified below:
(i)
The funds arising from discontinuance policies shall be shown
under a separate head in the Balance Sheet in the following manner:
(1)
Funds for discontinued policies
(a)
Discontinued on account of non-payment of premium;
(b)
Others
(2)
The amount refunded to the policyholders and amount transferred to
the "Funds for discontinued policies" during the financial year shall
be shown under a separate head.
(ii)
The following disclosures shall be made in the notes of the
accounts
(1)
Number of policies discontinued during the financial year;
(2)
Percentage of discontinued to total policies (product wise) during
the year;
(3)
Number and percentage of the policies revived during the year;
(4)
Charges imposed on account of discontinued policies.
CHAPTER-XV
Advertisements
Regulation 61. Advertisements.
(a)
An advertisement shall ensure the dissemination to all
policyholders of adequate, accurate, explicit and timely information fairly
printed in a simple language about:
(i)
A factual picture of inherent risks involved.
(ii)
Shall clearly distinguish the fact that the Linked products are
different from the traditional Life insurance products so that at no point of
time the prospective policy holders will be misled while choosing the Unit
Linked products.
(iii)
The risk factors associated with specific reference to
fluctuations in investment returns and the possibility of increase in charges.
(iv)
The premiums and funds are subject to certain charges related to
the fund or to the premium paid.
(v)
The contingency on which the guarantee, if any, is payable and the
exact quantum of such guarantee.
(b)
The terminology used in all the advertisements shall be simple,
concise and understandable to convey the exact meaning to the policyholders as
all of them may not be sophisticated in legal or financial matters and shall
avoid the usage of technical jargon and also terms which can have different
interpretations or detract the policyholders.
(c)
Care should be taken while reporting the past performance of the
funds in advertisements, as well as in any other promotional material like
sales illustrations, sales brochures etc. It should contain only the results of
the funds and be duly supported by related figures. The emphasis on past
performance must be reduced in the advertisements, however, past performance,
wherever intended to be reported, shall contain:
(i)
Compound annual returns (shall adopt standardized computations)
for the previous five calendar years, expressed as a percentage rounded to the
nearest 0.1%.
(ii)
Where last five calendar years data are not available, as many
years as possible must be shown.
(iii)
Where data is not available for at least one calendar year, past
performance shall not be shown.
(iv)
The life insurers shall not be permitted to demonstrate a link
between the past performance and the future.
(v)
It shall clearly state, in the same font, that the past
performance is not indicative of future performance.
(vi)
Corresponding benchmark index performance, if any, shall be
included.
(d)
All the advertisements of Linked Insurance products shall disclose
the risk factors as stated in the policy document along with the following
warning statements:
(i)
Linked Insurance products are different from the traditional
insurance products and are subject to the risk factors.
(ii)
The premium paid in Linked Insurance policies are subject to
investment risks associated with capital markets and the NAVs of the units may
go up or down based on the performance of fund and factors influencing the
capital market and the insured is responsible for his/her decisions.
(iii)
__________is only the name of the Insurance Company and______ is
only the name of the linked insurance contract and does not in any way indicate
the quality of the contract, its future prospects or returns.
(iv)
Please know the associated risks and the applicable charges, from
your Insurance agent or the Intermediary or policy document issued by the
insurance company.
(v)
The various funds offered under this contract are the names of the
funds and do not in any way indicate the quality of these plans, their future
prospects and returns.
(vi)
In view of the paucity of time and space, on the advertisements in
the hoardings and posters and in audio visual media, wherever the linked
insurance contract has been advertised, point nos. (ii) & (iii) shall have
a place invariably.
(e)
The advertisements shall not compare funds offered by one insurer
with funds offered by another insurer, implicitly or explicitly.
(f)
Any advertisement reproducing or purporting to reproduce any
information contained in as policy document shall reproduce such information in
full and disclose all relevant facts and not be restricted to select extracts
relating to that item which could be misleading.
(g)
Every advertisement shall comply with IRDA (Insurance
Advertisements and Disclosure) Regulations, 2000.
CHAPTER-XVI
Furnishing of Information
Regulation 62. Furnishing of Information to IRDA.
(a)
All the life insurers shall furnish data in respect of the
following information relating to their linked policies to the Authority in a
prescribed format every half year (Sept and March), to enable the Authority to
monitor the functioning of various options offered under linked policies with
respect to each product
(i)
Switching options exercised by the policy holder.
(ii)
Premium redirections exercised by the policy holders.
(iii)
Partial withdrawals allowed.
(iv)
Top-up premiums received.
(v)
Insurance cover multiple granted for each product separately for
Single Premium and non-Single Premium contracts.
(vi)
Expense ratios and fund performance for each fund.
(b)
Every insurer shall send a statement of account, on a half yearly
basis, within fifteen days, in respect of policies in force including
discontinued policies where the proceeds are yet to be paid to the policyholder
or her nominee as the case may be, his last known address, which shall contain
the following details:-
(i)
The total premium paid by the policyholder
(ii)
Next due date of the premium
(iii)
Pattern of the investment chosen
(iv)
Pattern of investment
(v)
Status of the policy
(vi)
Total fund value/policy account value
(vii)
Total units
(viii) Detail of
charges recovered.
(c)
Further, the above details shall also be submitted separately, in
respect of discontinued policies where the proceeds are yet to be paid to the policyholder
or her nominee as the case may be, his last known address.
(d)
A detailed analysis on the functioning and the performance of
discontinued policy fund/discontinued policy account value and the movements in
the fund shall be explained as a separate chapter in the Appointed Actuary
Annual Report.
(e)
The Authority may prescribe additional forms from time to time.
CHAPTER-XVII
Rating of Unit Linked Funds
Regulation 63. Rating of Unit Linked Funds.
The Insurers may move towards the
evaluation of their respective unit linked funds done by an independent rating
agency with an objective of providing qualitative information to the
policyholder as to the assessment of performance of the various unit linked
funds to enable the insuring public to choose the product in an informed
manner. This information shall provide the prospects a level of comfort on
operational practices, fund management quality, organizational strength of life
insurers. This may be initiated by the life insurers and life insurance council
on a voluntary basis.
CHAPTER-XVIII
Procedure for Implementation and Other provisions
Regulation 64. The insurers shall follow the following procedure for implementation of this regulation.
(a)
All existing products must be examined and ensured that they are in
conformity with these Regulations.
(b)
The Chief Executive Officer and the Appointed Actuary will certify
such compliance with regard to each product and submit such certificates to the
Authority in a consolidated form on or before 30th June, 2013 or 30th September,
2013 as applicable for Group and Individual products.
(c)
In case of products which are non-compliant with the provisions of
this regulation:
(i)
the modifications required to confirm to the provisions of this
Regulations does not include any change in the benefits offered, premium bases,
charges levied or any discounts offered in the products, than the insurer shall
carry out such modifications and file the modified File and Use for those
products along with the certification of the CEO and the AA that all the entire
File and Use after the modification is in conformity with the provision of this
Regulations and submit to the Authority before 30th June, 2013. The Authority
shall accept the file as final and allot the unique identification number.
However, later if such filings are found to be non-complaint with the
provisions of this Regulation, the Authority may initiate such action against
the said insurer, as deemed appropriate, under the provisions of the Act, the
Insurance Regulatory and Development Authority Act, 1999 and the relevant
regulations framed there under.
(ii)
For group products, the modifications required to confirm to the
provisions of this Regulations include any change in the benefits offered,
premium bases, charges levied or any discounts offered in the products, than
the insurer shall carry out such modifications and file the modified File and
Use for those products along with the certification of the CEO and the AA that
all the entire File and Use after the modification is in conformity with the
provision of this Regulations and submit to the Authority before 30th
September, 2013 for approval. The products submitted under File and Use for
approval shall clearly state the current provisions and the proposed provisions
in line with this regulation in a tabular form and also indicate the
implications on the pricing, reserving, profit margin etc, if any. The Insurer
shall file the products in a phased manner and avoid filing of all the products
at one time.
(iii)
For individual products, the modifications required to confirm to
the provisions of this Regulations include any change in the benefits offered,
premium bases, charges levied or any discounts offered in the products, than
the insurer shall carry out such modifications and file the modified File and
Use for those products along with the certification of the CEO and the AA that
all the entire File and Use after the modification is in conformity with the
provision of this Regulations and submit to the Authority before 30th
September, 2013 for approval. The products submitted under File and Use for
approval shall clearly state the current provisions and the proposed provisions
in line with this regulation in a tabular form and also indicate the
implications on the pricing, reserving, profit margin etc, if any. The Insurer
shall file the products in a phased manner and avoid filing of all the products
at one time.
(d)
In case of products which are already filed with the Authority,
but not approved, the files shall be returned for filing afresh in conformity
with this regulation.
(e)
All the existing group policies and all the existing individual
products not in conformity with the provisions of this regulation shall be
withdrawn from 1st July, 2013 and 1st October, 2013 respectively. No new
members shall be enrolled into the existing group policies once the product is
withdrawn. However, all group policies at the time of renewal of such policy
shall be given an option to switch over to the modified version of the group
product, if any, once introduced. Those group policies which do not switch over
to the modified version:
(i)
may continue to be renewed under the old policy;
(ii)
closed to new members and
(iii)
specific written consent is obtained by the group policyholder to
continue in the old policy.
(f)
Subject, to (e), this regulation shall not invalidate the linked
individual policies entered prior to this regulations coming into force.
(g)
All the insurers shall inform the prospective policyholders about
the possible changes in the products being sold during the transition period
and give an option to the existing policyholders including prospective
policyholders to switch over to the modified version if any, once introduced.
Regulation 65. Action in case of Default.
(a)
The Authority may, at any time, by an order in writing, direct any
officer of the Authority to inspect the affairs of any insurer and submit a
report on the reasonableness or otherwise of the compliance with the any of
these regulations
(b)
Upon receipt of the report, the Authority shall, after giving an
opportunity to the insurer to make a representation in connection with the
findings in the report, direct the insurer appropriately.
(c)
Without prejudice to the above, the Authority may also initiate
such action against the said insurer, as deemed appropriate, under the provisions
of the Act, the Insurance Regulatory and Development Authority Act, 1999 and
the relevant regulations framed there under.
(d)
All the insurers shall inform the prospective policyholders about
the possible changes in the products being sold during the transition period
and give an option to the existing policyholders including prospective
policyholders to switch over to the modified version if any, once introduced.
(e)
Where any product or feature of a product is cleared under File
and Use by the IRDA, such clearances for the same kind of product or feature
shall not be denied to any other insurer. However, the Authority reserves the
right to require insurers to withdraw a product or a feature of the product if
such is found not to be consistent with policyholder interests. In all such
cases, the Authority shall give three months notice for such withdrawal.
Regulation 66. Power of the Authority to issue clarifications.
In order to remove any
difficulties in respect of the application or interpretation of any of the
provisions of these regulations, the Authority may issue appropriate
clarifications or guidelines, as and when required.
Regulation 67. Repeal and Savings.
(a)
The IRDA (Treatment of discontinued policies) Regulation, 2010,
all the guidelines/clarifications/circulars/letters issued in respect of the
unit linked insurance products. Pension and Variable insurance products and
Regulation 19 of the IRDA (INSURANCE BROKERS) REGULATIONS, 2002 shall be
repealed from the date this regulation comes into force.
(b)
Unless otherwise provided by these regulations, nothing in these
regulations shall deem to invalidate the Unit finked insurance, Pension and
Variable insurance contracts entered prior to these regulations coming into
force.
Regulation 68. Review of the guidelines.
The Authority has power to make a
detailed review of the guidelines on an ongoing basis for such modifications as
may be deemed necessary towards protection of the interests of the
policyholders
Substituted
by Circular No. IRDA/ACT/CIR/PRD/089/03/2013-2014 Dated 21.03.2014 for the
following : -
a. Collection of advance premium
under individual linked products shall not be allowed except in the following cases:
i) The premium due may be
accepted 30 days before the date of due of payment of premium. However, the
commission shall only be paid on the premium due date
ii) For monthly premium payment
mode, the insurer may accept three months' premiums in advance only on the date
of commencement of policy, if it is a prerequisite to allow monthly mode of
premium payment and is allowed under File and Use.