Datasets:

suyashhchougule

/

new_vlm_finetune_checklist_dataset

like 0

[ { "section_name": "3. Varied segments and varied risks in General Insurance", "short_title": "Review Loss Prevention Approaches", "action_item": "Review the different approaches to loss prevention and minimization in various areas of general insurance, such as Fire Insurance, Marine Insurance, and Motor Third Party Insurance, to verify that they are being implemented effectively." }, { "section_name": "3. Varied segments and varied risks in General Insurance", "short_title": "Verify Training and Housekeeping", "action_item": "Verify that workers in Fire Insurance are receiving training in the use of fire-fighting appliances and that good industrial housekeeping practices are being followed." }, { "section_name": "3. Varied segments and varied risks in General Insurance", "short_title": "Check Cargo Supervision", "action_item": "Check that supervision of loading and unloading of cargo is being conducted in Marine Insurance to prevent losses." }, { "section_name": "3. Varied segments and varied risks in General Insurance", "short_title": "Review Accident Response", "action_item": "Review the procedures in place for containing leakage of a tanker in the event of an accident in Marine Insurance to minimize loss of contents." }, { "section_name": "3. Varied segments and varied risks in General Insurance", "short_title": "Verify Public Awareness", "action_item": "Verify that public awareness campaigns are being conducted to inform policyholders of their rights and responsibilities in Motor Third Party Insurance." }, { "section_name": "3. Varied segments and varied risks in General Insurance", "short_title": "Review Road Safety Measures", "action_item": "Review the measures being taken to improve road safety, such as those introduced by MoRTH and the SC Committee on Road Safety, to verify that they are being implemented effectively by the insurance company." }, { "section_name": "3. Varied segments and varied risks in General Insurance", "short_title": "Assess Cyber Risk", "action_item": "Assess the vulnerabilities associated with cyber risk in the insurance industry and verify that adequate measures are being taken to mitigate these risks." }, { "section_name": "4. Role of General Insurers", "short_title": "Review Loss Prevention Activities", "action_item": "Review the methods used by the insurer to disseminate knowledge and information on loss prevention and minimization, including both formal and informal means." }, { "section_name": "4. Role of General Insurers", "short_title": "Verify Risk Assessment Process", "action_item": "Verify that the insurer conducts risk assessments, and where required, takes the help of experts to carry out these assessments." }, { "section_name": "4. Role of General Insurers", "short_title": "Check Risk Improvement Suggestions", "action_item": "Check that the insurer suggests risk improvements to policyholders based on the risk assessment findings." }, { "section_name": "4. Role of General Insurers", "short_title": "Review Customer Education", "action_item": "Review the processes in place for educating customers regarding loss prevention and minimization." }, { "section_name": "4. Role of General Insurers", "short_title": "Verify Surveyor's Role in Loss Mitigation", "action_item": "Verify that the surveyor plays an active role in mitigating losses at the point of claim, and review the procedures in place for this process." } ]

[ { "section_name": "", "short_title": "Review Industry-Wide Risk Analysis", "action_item": "Review if the organization conducts or participates in industry-wide analyses of risks to identify potential areas for loss prevention and minimization." }, { "section_name": "", "short_title": "Verify Education and Awareness Programs", "action_item": "Verify if the organization has education and awareness programs in place for clients and staff on the need for and methodologies of preventing and minimizing losses." }, { "section_name": "", "short_title": "Check Knowledge Sharing Practices", "action_item": "Check if the organization participates in knowledge sharing of experience relating to loss prevention and minimization with other insurers or industry stakeholders." }, { "section_name": "", "short_title": "Review Client Education Initiatives", "action_item": "Review the organization's client education initiatives, including risk inspections and client seminars, to ensure they are adequate and effective in promoting loss prevention and minimization." }, { "section_name": "5. Property loss control solution transcending time and geography", "short_title": "Review Property Insurers' Data Analysis", "action_item": "Review whether property insurers are analyzing their big data on property loss to identify causes of losses and potential solutions, considering the requirements for a multi-disciplinary approach, research facilities, and collaboration with industry and academia." }, { "section_name": "5. Property loss control solution transcending time and geography", "short_title": "Verify Loss Control Practices", "action_item": "Verify that the existing loss control practices of the insurers are aligned with their primary function of underwriting and are aimed at reducing the frequency and severity of losses, which would benefit both insurers and insureds by lowering overall burning costs and premium rates." }, { "section_name": "7. Education and Expertise are key", "short_title": "Review Education Programs", "action_item": "Review the organization's education programs to verify that they include key components in loss prevention and mitigation, such as safety measures against fire and following rules while driving." }, { "section_name": "7. Education and Expertise are key", "short_title": "Verify Communication Channels", "action_item": "Verify that the organization uses various media channels to communicate loss prevention and safety education to the general public, including print (booklets, brochures), electronic (audio and video), and other appropriate channels in rural areas." }, { "section_name": "7. Education and Expertise are key", "short_title": "Check Seminar and Webinar Programs", "action_item": "Check if the organization conducts seminars and webinars on loss prevention and safety, and review their content to ensure it aligns with the organization's education goals." } ]

[]

[ { "section_name": "2. South Africa", "short_title": "Review National Traffic Call Centre (NTCC) Establishment", "action_item": "Review the establishment of the National Traffic Call Centre (NTCC) in South Africa to report incidents such as bad drivers, unsafe vehicles, overloading, and corruption in vehicle testing stations." }, { "section_name": "2. South Africa", "short_title": "Verify RTMC Act, 1999 Compliance", "action_item": "Verify that the organization complies with the RTMC Act, 1999 of South Africa, which aims to develop the quality and safety of road transport." }, { "section_name": "2. South Africa", "short_title": "Check Traffic Personnel Training", "action_item": "Check if traffic personnel have received the necessary training as mandated by the RTMC Act, 1999." }, { "section_name": "2. South Africa", "short_title": "Review Infrastructure Safety Audits", "action_item": "Review the infrastructure safety audits carried out by the relevant authorities to ensure they meet the required standards." }, { "section_name": "2. South Africa", "short_title": "Verify Accident Investigations", "action_item": "Verify that accident investigations are being carried out as required by the RTMC Act, 1999." }, { "section_name": "2. South Africa", "short_title": "Check Public Education on Road Safety", "action_item": "Check if the organization is communicating and educating the public about road safety aspects, including the concept of Arrive Alive." }, { "section_name": "2. South Africa", "short_title": "Review Compulsory Motor Insurance", "action_item": "Review the organization's compliance with the compulsory Motor Insurance requirement in South Africa." }, { "section_name": "2. South Africa", "short_title": "Verify Loss Control Coordination", "action_item": "Verify that the organization is coordinating with the Prudential Authority of South Africa (Insurance Regulator) on Loss Control, with the assistance of Government Agencies." } ]

[ { "section_name": "", "short_title": "Review NFPA Codes and Standards", "action_item": "Review the organization's compliance with NFPA codes and standards, which are designed to minimize the risk and effects of fire by establishing criteria for building, processing, design, service, and installation." }, { "section_name": "", "short_title": "Verify Access to NFPA Codes and Standards", "action_item": "Verify that the organization has access to NFPA codes and standards, which are available for free online, to ensure that the organization is using the most up-to-date information." }, { "section_name": "", "short_title": "Check Compliance with NFPA Criteria", "action_item": "Check the organization's compliance with NFPA criteria for building, processing, design, service, and installation to minimize the risk and effects of fire." }, { "section_name": "3.5 FM Global", "short_title": "Review FM Global Data Sheet", "action_item": "Review the FM Global data sheet to verify that it provides the standards and codes for various occupancies for property loss prevention." }, { "section_name": "3.5 FM Global", "short_title": "Verify Compliance with FM Global Standards", "action_item": "Verify that the organization's property loss prevention practices comply with the standards and codes provided by FM Global." }, { "section_name": "3.5 FM Global", "short_title": "Check Adoption of FM Global Services", "action_item": "Check if the organization has adopted any of the services provided by FM Global, such as predictive analytics, claims, cyber risk assessment, business risk consulting, supply chain risk management, or appraisal." }, { "section_name": "3.5 FM Global", "short_title": "Review FM Global Research Campus Findings", "action_item": "Review the findings and research conducted by the FM Global Research Campus, particularly in the areas of fire technology, natural hazards, electrical hazards, and hydraulics, to identify potential risks and areas for improvement." } ]

[]

[ { "section_name": "", "short_title": "Review RISC Authority Activities", "action_item": "Review the activities carried out by the RISC Authority in the UK, including stakeholder engagement, standards representation, information gathering and data analytics, creation of data and loss case study repository, research and testing, production of best-practice guides, development of loss control tool kits, dissemination of knowledge and information, and synergizing with stakeholders." }, { "section_name": "", "short_title": "Verify Stakeholder Engagement", "action_item": "Verify that the RISC Authority engages with stakeholders through seminars, webinars, and research in specific classes of occupancies for property protection." }, { "section_name": "", "short_title": "Check Standards Representation", "action_item": "Check that the RISC Authority represents insurers in safety standard/codes development committees, testing, and other relevant activities." }, { "section_name": "", "short_title": "Review Information Gathering and Data Analytics", "action_item": "Review the RISC Authority's processes for gathering information and performing data analytics for the purpose of loss control." }, { "section_name": "", "short_title": "Verify Data and Loss Case Study Repository", "action_item": "Verify that the RISC Authority creates and maintains a repository of data and loss case studies, including risk survey reports, videos, photos, and summary reports of post-loss studies." }, { "section_name": "", "short_title": "Check Research and Testing Facilities", "action_item": "Check that the RISC Authority carries out research and testing in the area of loss control." }, { "section_name": "", "short_title": "Review Best-Practice Guides", "action_item": "Review the best-practice guides produced by the RISC Authority to ensure they are relevant and effective." }, { "section_name": "", "short_title": "Verify Loss Control Tool Kits", "action_item": "Verify that the RISC Authority develops and maintains loss control tool kits, including both conventional checklists and digital tools utilizing IoT, drones, AI, analytics, etc." }, { "section_name": "", "short_title": "Check Dissemination of Knowledge and Information", "action_item": "Check that the RISC Authority disseminates knowledge and information to stakeholders through web portals, professional journals, bulk messaging, and other relevant channels." }, { "section_name": "", "short_title": "Review Synergizing Efforts", "action_item": "Review the RISC Authority's efforts to create a win-win atmosphere for stakeholders and verify that these efforts are effective." } ]

[ { "section_name": "", "short_title": "Review of Critical and High Priority Recommendations", "action_item": "Review the most recent survey report to verify if all critical and high priority recommendations have been acted upon within a year after the report was produced." }, { "section_name": "", "short_title": "Verification of Insurance Cover", "action_item": "Verify that no insurance cover has been offered if critical and high priority recommendations made in the most recent survey report have not been acted upon for more than a year after the report was produced." }, { "section_name": "", "short_title": "Review of Low Priority Recommendations", "action_item": "Review the most recent survey report to identify any low priority recommendations that have not been actioned more than a year after the report was produced." }, { "section_name": "", "short_title": "Verification of Additional Premium or Exclusions", "action_item": "Verify that the Company has collected additional premium, imposed exclusions, or applied additional deductibles relating to low priority recommendations that have not been actioned more than a year after the report was produced." }, { "section_name": "", "short_title": "Check of Appropriate Measures", "action_item": "Check if the measures taken by the Company (additional premium, exclusions, or additional deductibles) are appropriate and relate to the low priority recommendations that have not been actioned." } ]

[]

[ { "section_name": "3. Current practices in loss control by insurers", "short_title": "Review Loss Control Practices", "action_item": "Review the organization's property loss prevention and loss minimization practices to verify if they are in line with industry standards and if a dedicated loss control team or department is in place." }, { "section_name": "3. Current practices in loss control by insurers", "short_title": "Verify Underwriting Practices", "action_item": "Verify that the organization's underwriting practices include prudent risk selection based on risk inspection, and that risk inspection reports are used as the basis for underwriting decisions." }, { "section_name": "3. Current practices in loss control by insurers", "short_title": "Check Claims Management Practices", "action_item": "Check the organization's claims management practices to verify if they are prudent and include measures for investigation and fraud control." }, { "section_name": "3. Current practices in loss control by insurers", "short_title": "Review Risk Management Practices", "action_item": "Review the organization's risk management practices to verify if they include measures for risk assessment, risk improvement suggestions, and Probable Maximum Loss (PML) assessment." }, { "section_name": "3. Current practices in loss control by insurers", "short_title": "Verify Risk Inspection Practices", "action_item": "Verify if the organization has in-house independent surveys by risk engineers, and if the reports from these surveys provide risk assessment based on COPE features of a risk, risk improvement suggestions, and PML assessment." }, { "section_name": "3. Current practices in loss control by insurers", "short_title": "Check for Dedicated Risk Engineering Department", "action_item": "Check if the organization has a dedicated risk engineering department, and if not, verify what alternative arrangements are in place for risk inspection and assessment." }, { "section_name": "4. Survey by private surveyors/brokers", "short_title": "Review Risk Survey Reports", "action_item": "Review risk survey reports provided by private surveyors, brokers, or in-house engineers to verify that they contain a clear risk analysis and Probable Maximum Loss (PML) to enable sound underwriting and risk improvement recommendations." }, { "section_name": "4. Survey by private surveyors/brokers", "short_title": "Verify Survey Report Quality", "action_item": "Verify that the quality of the survey report is adequate, considering factors such as the quality of the risk engineer, co-operation of the client and broker, duration of survey, scope of survey, planning and scheduling of survey, independent survey or joint survey, availability of plant engineers, and availability of data." }, { "section_name": "4. Survey by private surveyors/brokers", "short_title": "Check Risk Improvement Recommendations", "action_item": "Check that every risk survey report contains risk improvement recommendations based on assorted codes and best practices, and that these recommendations are classified based on cost-benefit, criticality, and physical improvement." }, { "section_name": "4. Survey by private surveyors/brokers", "short_title": "Review Implementation of Recommendations", "action_item": "Review the implementation of risk improvement recommendations, including those that involve expenditure for implementation and those that are safety process improvements with no or minimal cost to the insured." }, { "section_name": "4. Survey by private surveyors/brokers", "short_title": "Verify Survey Process", "action_item": "Verify that the survey process is conducted in a manner that minimizes distractions and allows for quality discussions, and that the survey is planned and scheduled adequately to avoid overcrowding and seasonality issues." } ]

[ { "section_name": "", "short_title": "Review Risk Survey Practices", "action_item": "Review the current risk survey practices to identify areas for improvement and verify if they are being effectively implemented to control losses." }, { "section_name": "", "short_title": "Verify Compliance Rate", "action_item": "Verify the compliance rate of critical recommendations made by insurers and check if they are being implemented or remaining on paper." }, { "section_name": "", "short_title": "Analyze Cost-Benefit Analysis", "action_item": "Analyze the cost-benefit analysis of implementing suggestions made by insurers and review if it is encouraging or impractical." }, { "section_name": "", "short_title": "Check Premium Loading for Poor Risks", "action_item": "Check if the organization has a policy of loading premium for poor risks and verify if it is being applied consistently." }, { "section_name": "", "short_title": "Review Warranty in Policy", "action_item": "Review the policy to check if there is a warranty that critical suggestions made by insurers need to be complied with and verify if it is being enforced." } ]

[ { "section_name": "2. Risk inspection by Surveyors /Risk Engineers", "short_title": "Review Risk Inspection Team Composition", "action_item": "Review the composition of the risk inspection team to verify that it includes a blend of core talent and manpower from the relevant domain or class of occupancy of high exposure risk, as well as experienced risk engineers and loss control professionals from the insurance industry." }, { "section_name": "2. Risk inspection by Surveyors /Risk Engineers", "short_title": "Verify Central Repository of Risk Inspection Reports", "action_item": "Verify that a central repository of all Risk Inspection Reports (insured-wise) has been created, and check that access is provided to insurers after masking information that might involve confidentiality." }, { "section_name": "2. Risk inspection by Surveyors /Risk Engineers", "short_title": "Check Access Controls for Risk Inspection Reports", "action_item": "Check that access controls are in place to ensure that only authorized personnel have access to the central repository of Risk Inspection Reports, and that confidential information is properly masked before being shared with insurers." }, { "section_name": "2. Risk inspection by Surveyors /Risk Engineers", "short_title": "Review Knowledge-Sharing Initiatives", "action_item": "Review the knowledge-sharing initiatives in place to verify that they are effective in sharing information and best practices among stakeholders, while maintaining confidentiality and data protection." } ]

[ { "section_name": "3. Conducting post loss studies", "short_title": "Review Post Loss Survey Conductance", "action_item": "Review whether the proposed loss control body conducts post loss surveys for large losses exceeding the set value, and verify that the surveys are conducted in accordance with established procedures." }, { "section_name": "3. Conducting post loss studies", "short_title": "Verify Report Sharing", "action_item": "Verify that the detailed report with root cause analysis and suggested measures to prevent or mitigate future losses is shared by the proposed loss control body after conducting post loss surveys." }, { "section_name": "3. Conducting post loss studies", "short_title": "Check Report Content", "action_item": "Check that the detailed report includes root cause analysis and suggested measures to help prevent or mitigate such losses in the future, and review the report for completeness and accuracy." }, { "section_name": "3. Conducting post loss studies", "short_title": "Evaluate Loss Prevention Measures", "action_item": "Evaluate whether the suggested measures to prevent or mitigate future losses are implemented and effective, and verify that the measures are reviewed and updated as necessary." }, { "section_name": "5. Collaboration with IIBI on loss data", "short_title": "Review Loss Data Collection", "action_item": "Review the process of collecting loss data to verify that it is being done in a granular manner, including geo-coding, to support effective loss control functions." }, { "section_name": "5. Collaboration with IIBI on loss data", "short_title": "Verify Database Analysis", "action_item": "Verify that the database created for loss data is being studied, analyzed, and interpreted by individuals who understand occupancy exposure, and that stakeholders are validating the findings." }, { "section_name": "5. Collaboration with IIBI on loss data", "short_title": "Check Loss Data Segmentation", "action_item": "Check that the loss control body, together with IIBI, is collecting and building segment-wise and occupancy-wise loss data, including geo-coding, to present a comprehensive view of loss patterns." }, { "section_name": "5. Collaboration with IIBI on loss data", "short_title": "Review Loss Pattern Analysis", "action_item": "Review the analysis of loss patterns to verify that it includes information on root causes, severity of loss, and applicable loss prevention and mitigation techniques learned from past losses." }, { "section_name": "5. Collaboration with IIBI on loss data", "short_title": "Verify Application of Loss Prevention Techniques", "action_item": "Verify that loss prevention and mitigation techniques learned from past losses are being applied to avoid reoccurrence, and that the loss control body is presenting a snapshot view of this information." }, { "section_name": "6. Forensic studies", "short_title": "Review Forensic Study Capabilities", "action_item": "Review whether the loss control body has built capabilities relating to forensic studies, and verify that these capabilities are adequate and operational." }, { "section_name": "7. Conduct safety audit and safety training", "short_title": "Review Safety Management Exercises", "action_item": "Review the organization's safety management exercises to verify that they are being undertaken as required." }, { "section_name": "7. Conduct safety audit and safety training", "short_title": "Verify Periodic Safety Audit Training", "action_item": "Verify that the organization is conducting periodic training on safety audits for its businesses." }, { "section_name": "7. Conduct safety audit and safety training", "short_title": "Check Training for Fire Officers and Firemen", "action_item": "Check that the organization is providing training for fire officers and firemen for company fire brigades." }, { "section_name": "7. Conduct safety audit and safety training", "short_title": "Review Economic Rehabilitation Training", "action_item": "Review the organization's training programs to verify that they include economic rehabilitation after a major loss." } ]

[ { "section_name": "8. Cargo Loss prevention", "short_title": "Review Loss Minimization Activities", "action_item": "Review the body's involvement in loss minimization activities in major ports, including supervision of cargo discharge, follow-up of safety clearance, safe guarding of cargo, and tracing of missing cargo." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Verify Expert Advice on Special Cargo", "action_item": "Verify that the body provides expert advice on the transport of special cargo and supervision of loading and unloading activities, as well as tracking transits." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Check Security Systems and Training", "action_item": "Check if the body has studied security systems in industrial and storage premises, devised model security systems, organized, and provided training for security staff." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Review Packaging Audits", "action_item": "Review the body's liaison with the Indian Institute of Packaging and conduct of packaging audits." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Inspect Infrastructure at Rail Siding and Stations", "action_item": "Inspect the infrastructure at rail sidings and stations and verify if measures are suggested to control theft, wet losses, etc." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Verify Asset Tracking by GPS", "action_item": "Verify if the body has implemented asset tracking by GPS and chip mounting on cargos and cargo trucks." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Check Integration of GSTN and Online Way Bill Databases", "action_item": "Check if the body has integrated GSTN and online Way Bill databases to track consignments and reduce claim settlement TAT." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Review Collaboration with Meteorological Agencies", "action_item": "Review the body's collaboration with Meteorological agencies for sending pre-emptive safety advisories before/during inclement weather." }, { "section_name": "8. Cargo Loss prevention", "short_title": "Verify Implementation of HSN Codes", "action_item": "Verify if the body has implemented internationally accepted HSN codes to standardize cargo categorization." }, { "section_name": "9. Effectiveness to be measured", "short_title": "Review Loss Control Body Metrics", "action_item": "Review and verify that the quality of the activities of the loss control body, its function and performance are measured by appropriate metrics such as customer feedback and loss ratio/burning cost improvements." }, { "section_name": "9. Effectiveness to be measured", "short_title": "Verify Burning Cost Reduction", "action_item": "Check that the loss control body has implemented measures to bring down the burning cost segment-wise and occupancy-wise, and verify the effectiveness of these measures." }, { "section_name": "9. Effectiveness to be measured", "short_title": "Evaluate Loss Control Body Capabilities", "action_item": "Verify that the loss control body has built capabilities and excels in its sphere of activity, and review the body's performance in achieving its objectives." }, { "section_name": "10. Current practices in risk survey and loss control", "short_title": "Review Property Loss Prevention Practices", "action_item": "Review the property loss prevention and minimization practices to verify if they are consistent and uniform across all insurers, and document any variations found." }, { "section_name": "10. Current practices in risk survey and loss control", "short_title": "Verify Survey Report Quality", "action_item": "Verify the quality of survey reports to check for consistency and accuracy, and review the factors that may affect the quality of the reports, such as the quality of the risk engineer, client and broker co-operation, and data availability." }, { "section_name": "10. Current practices in risk survey and loss control", "short_title": "Check Loss Control Measures", "action_item": "Check the loss control measures in place and verify if they are adequate and effective, considering factors such as planning and scheduling of surveys, overloading, and seasonality of surveys." }, { "section_name": "10. Current practices in risk survey and loss control", "short_title": "Evaluate Risk Engineer Quality", "action_item": "Evaluate the quality of the risk engineers conducting surveys to verify if they have the necessary expertise and experience to produce high-quality survey reports." }, { "section_name": "10. Current practices in risk survey and loss control", "short_title": "Assess Client and Broker Co-operation", "action_item": "Assess the level of co-operation from clients and brokers during the survey process to verify if it is adequate and if it affects the quality of the survey reports." }, { "section_name": "10. Current practices in risk survey and loss control", "short_title": "Review Survey Duration and Scheduling", "action_item": "Review the duration and scheduling of surveys to verify if they are adequate and if they allow for sufficient time to collect and analyze data." }, { "section_name": "10. Current practices in risk survey and loss control", "short_title": "Verify Data Availability", "action_item": "Verify if relevant data is available at the survey site and if it is accessible to the risk engineers, and document any instances where data was not available or was insufficient." } ]

[ { "section_name": "", "short_title": "Review Joint Surveys", "action_item": "Review the process of conducting Joint Surveys by groups of risk engineers of various companies/underwriters and sales members to verify that they are being conducted as described, and that the group is properly assessing the risk during these surveys." }, { "section_name": "", "short_title": "Verify Engagement of Loss Surveyors", "action_item": "Verify that insurers are engaging loss surveyors, such as chartered engineers, to survey risks when deemed fit or mandatory, and that this is being done in the absence of available in-house risk engineers." }, { "section_name": "", "short_title": "Check Survey Documentation", "action_item": "Check that all risk surveys, whether conducted by in-house risk engineers or external loss surveyors, are properly documented and that the survey reports are accurate and complete." }, { "section_name": "11. Survey report format and PML working to be standardized", "short_title": "Review Survey Report Format Standardization", "action_item": "Review the survey report formats used for COPE (Construction, Occupancy, Protection and Exposure) information to verify if a standardized format is being used across all surveys and reports." }, { "section_name": "11. Survey report format and PML working to be standardized", "short_title": "Verify PML Working Standardization", "action_item": "Verify if a common methodology for PML (Probable Maximum Loss) working and risk scoring has been established and is being used consistently across all surveys and reports." }, { "section_name": "11. Survey report format and PML working to be standardized", "short_title": "Check for Consistency in Reports and Findings", "action_item": "Check the reports and findings for consistency, and verify that the use of standardized report formats and common methodology for PML working and risk scoring has minimized inconsistencies." }, { "section_name": "14. Marine Cargo related steps", "short_title": "Review Existing Regulations", "action_item": "Review existing regulations related to marine cargo with relevant stakeholders, including ship owners, insurers, road transport authorities, and BIS, to identify areas for modification and unification." }, { "section_name": "14. Marine Cargo related steps", "short_title": "Verify Coordination with Authorities", "action_item": "Verify that coordination with police, port authorities, and customs authorities is in place to prevent theft, pilferage, and burglaries related to marine cargo." } ]

[ { "section_name": "18. Infrastructure for the loss prevention institution", "short_title": "Review Infrastructure", "action_item": "Review the infrastructure of the loss prevention institution to verify that it has state-of-the-art facilities, including research and training facilities, laboratory, and testing facilities comparable to globally recognized institutes such as FPA, NFPA, and FM." }, { "section_name": "18. Infrastructure for the loss prevention institution", "short_title": "Verify Risk Management Expertise", "action_item": "Verify that the loss prevention institution has developed excellent risk management and loss control expertise, supported by its infrastructure." }, { "section_name": "18. Infrastructure for the loss prevention institution", "short_title": "Check Global Standards", "action_item": "Check if the infrastructure and facilities of the loss prevention institution are on par with globally known institutes like FPA, NFPA, and FM." } ]

[ { "section_name": "Chapter 6 Loss prevention and Minimization in Motor Insurance 1.Motor Insurance products", "short_title": "Review Motor Insurance Product Segmentation", "action_item": "Review the segmentation of Motor Insurance products in India to verify that they are divided into Private and Commercial Vehicles, apart from Miscellaneous Types of vehicles." }, { "section_name": "Chapter 6 Loss prevention and Minimization in Motor Insurance 1.Motor Insurance products", "short_title": "Verify Coverage Perspectives", "action_item": "Verify that the Motor Insurance business is segmented from the coverage perspective into Damage to Insured Vehicle (Own Damage) and Damage to Third parties as per the Motor Vehicles Act." }, { "section_name": "2. Role of Surveyors and Institutions in Loss Control", "short_title": "Review Surveyor and Investigator Roles", "action_item": "Review the roles and responsibilities of surveyors and investigators in loss control to verify their contribution to minimizing fraud and controlling inflated claims." }, { "section_name": "2. Role of Surveyors and Institutions in Loss Control", "short_title": "Verify Data Collection on Repair Parts", "action_item": "Verify that average price data on repair of parts is collected and maintained, and check if an OEM-wise database is used to standardize category-wise labour rates." }, { "section_name": "2. Role of Surveyors and Institutions in Loss Control", "short_title": "Check Analysis of Surveyor Findings", "action_item": "Check if the findings shared by surveyors are properly captured and analysed, and review the process for analysing the data to identify potential areas for loss control." }, { "section_name": "2. Role of Surveyors and Institutions in Loss Control", "short_title": "Review Institution Involvement in Fraud Monitoring", "action_item": "Review the involvement of institutions like IIBI in fraud monitoring and verify that they are analysing data to contribute to loss control efforts." }, { "section_name": "2. Role of Surveyors and Institutions in Loss Control", "short_title": "Verify Use of Deep Learning Techniques", "action_item": "Verify if deep learning techniques are being used by a focused body to supplement fraud monitoring efforts and help minimize losses." } ]

[ { "section_name": "6.1 Block Chain", "short_title": "Review Block Chain Integration", "action_item": "Review the integration of block chain technology with various stakeholders including Insurance Companies, IRDAI, IIBI, Road Transport Authority, Police Department, and Ministry of Road Transport and Highways (MORTH) to verify that all stakeholders are on the same page." }, { "section_name": "6.1 Block Chain", "short_title": "Verify Data Hosting", "action_item": "Verify that the data is hosted on a country-based cloud hosting platform to ensure compliance with regulatory requirements." }, { "section_name": "6.1 Block Chain", "short_title": "Check Uninsured Vehicle Identification", "action_item": "Check the process of identifying uninsured vehicles using block chain technology and verify that it is functioning as intended." } ]

[ { "section_name": "", "short_title": "Review Vehicle Segregation", "action_item": "Review the segregation of vehicles based on manufacturing details to verify compliance with Emission guidelines during the renewal of Insurance." }, { "section_name": "", "short_title": "Verify Loss Prevention Body Enablement", "action_item": "Verify that the Loss Prevention Body has enabled insurers to share further details of exposure and claims through the use of new technology like Block chain for seamless sharing to prevent frauds." }, { "section_name": "", "short_title": "Check Shared Details", "action_item": "Check that the shared details include Pre-Inspection photos, Pre-settlement claim details, and On spot settlement claim details for subsequent insurance." }, { "section_name": "", "short_title": "Review Database Integration", "action_item": "Review the integration of databases such as Sarathi (driver), FASTAG (RFID), and traffic violations to verify that they are properly linked and accessible." }, { "section_name": "6.2 Identify pain points with Data Analytics and Artificial Intelligence", "short_title": "Review Data Analytics and AI for Motor Loss Prevention", "action_item": "Review the use of Data Analytics and Artificial Intelligence for Motor Loss prevention to verify that it is being utilized to analyze vehicle features and user behavior." }, { "section_name": "6.2 Identify pain points with Data Analytics and Artificial Intelligence", "short_title": "Verify Analysis of Vehicle Features", "action_item": "Verify that Data Analytics and Artificial Intelligence are being used to analyze the features of vehicles for Motor Loss prevention." }, { "section_name": "6.2 Identify pain points with Data Analytics and Artificial Intelligence", "short_title": "Verify Analysis of User Behavior", "action_item": "Verify that Data Analytics and Artificial Intelligence are being used to analyze the behavior of users for Motor Loss prevention." }, { "section_name": "7. Demographic Reach", "short_title": "Review Demographic Reach", "action_item": "Review the organization's understanding of the cause and consequence of large loss geographies, including major Frauds, theft prone locations, and Red flagged accident zones, to verify that it is comprehensive and up-to-date." }, { "section_name": "7. Demographic Reach", "short_title": "Verify Identification of High-Risk Areas", "action_item": "Verify that the organization has identified high-risk areas, including National and State Highways, which contribute to a significant percentage of accidents, and that appropriate measures are in place to mitigate these risks." }, { "section_name": "7. Demographic Reach", "short_title": "Check Analysis of Chronic Claimants", "action_item": "Check that the organization has analyzed data on chronic claimants and has implemented strategies to address and prevent fraudulent or excessive claims." }, { "section_name": "8. Best Practice Guidelines", "short_title": "Review Vehicle Inspection Guidelines", "action_item": "Review the standard guidelines on the inspection of vehicles to verify that they are based on the age and model of the vehicle." }, { "section_name": "8. Best Practice Guidelines", "short_title": "Verify Loss Event Procedures", "action_item": "Verify that the guidelines outline the acts to be performed or not performed in the event of a loss, and that these procedures are clearly documented." }, { "section_name": "8. Best Practice Guidelines", "short_title": "Check Precautions for Insured", "action_item": "Check that the guidelines include precautions to be taken by the Insured to prevent losses, and that these precautions are communicated to the Insured." }, { "section_name": "8. Best Practice Guidelines", "short_title": "Review Best Practices for Loss Events", "action_item": "Review the best practices to be adopted in the event of a loss or during a particular season where losses are common, and verify that these practices are followed." }, { "section_name": "8. Best Practice Guidelines", "short_title": "Verify Seasonal Loss Prevention", "action_item": "Verify that the guidelines include special precautions or best practices to be taken during seasons where losses are common, and that these are communicated to the Insured." } ]

[ { "section_name": "13. Collaboration with Traffic Police for training curriculum", "short_title": "Review Collaboration with IIBI", "action_item": "Review whether the body collaborates with IIBI on sharing of traffic violations and arranging education and training programmes for chronic violators." }, { "section_name": "13. Collaboration with Traffic Police for training curriculum", "short_title": "Verify Collaboration with State Police", "action_item": "Verify that the body collaborates with the state police in establishing a training curriculum for traffic violators." }, { "section_name": "13. Collaboration with Traffic Police for training curriculum", "short_title": "Check Training Curriculum Coverage", "action_item": "Check if the training curriculum established in collaboration with the state police covers specific topics such as red light jumping and drunken driving offences." }, { "section_name": "13. Collaboration with Traffic Police for training curriculum", "short_title": "Review Education and Training Programmes", "action_item": "Review the education and training programmes arranged for chronic violators to ensure they are implemented as planned." } ]

[]

[]

[ { "section_name": "6. Terms of Reference:", "short_title": "Review Loss Prevention and Loss Minimisation Practices", "action_item": "Review the current practices followed by the insurance industry in the area of Loss Prevention and Loss Minimisation to identify areas for improvement." }, { "section_name": "6. Terms of Reference:", "short_title": "Verify Segment-wise Improvement Suggestions", "action_item": "Verify that segment-wise ways and means to improve Loss Prevention and Loss Minimisation in insurance are suggested and documented." }, { "section_name": "6. Terms of Reference:", "short_title": "Check Stakeholder Synergisation Approach", "action_item": "Check if an approach to synergise the activities of the various stakeholders involved in Loss Prevention and Loss Minimisation is suggested and implemented." }, { "section_name": "6. Terms of Reference:", "short_title": "Review Research and Education Recommendations", "action_item": "Review the recommendations provided for promoting research, education, and services related to Loss Prevention and Loss Mitigation." }, { "section_name": "6. Terms of Reference:", "short_title": "Verify Report Submission Timeline", "action_item": "Verify that the Working Group submits a report containing its recommendations within twelve weeks of the date of the order." } ]

[]

[]

[]

[]

[]

[ { "section_name": "", "short_title": "Review of Compliance with Independence Requirements", "action_item": "Review and verify if the auditor has complied with the independence requirements for auditors laid down under the Companies Act and the Code of Ethics mandated by the Institute of Chartered Accountants of India, specifically in relation to the provision of non-audit services." }, { "section_name": "", "short_title": "Verification of Net Owned Funds (NOF) and Capital to Risk Assets Ratio (CRAR)", "action_item": "Check and verify if the Non-Banking Financial Company (NBFC) has complied with the minimum Net Owned Funds (NOF) and Capital to Risk Assets Ratio (CRAR) prescribed, and review the Financial Statements to ensure accurate disclosure of these numbers." }, { "section_name": "", "short_title": "Review of Financial Statements for Material Misstatements", "action_item": "Review the Financial Statements to identify any material misstatements, including those related to the reversal of General Contingency Provision, valuation of derivative assets, and provision for impairment in the value of investments, and verify if the auditor has highlighted these misstatements in the Auditor's Report." }, { "section_name": "", "short_title": "Verification of Audit Evidence for Financial Statement Items", "action_item": "Verify if the auditor has obtained sufficient and appropriate audit evidence to support the numbers reported in the Financial Statements, specifically in relation to the reversal of General Contingency Provision, valuation of derivative assets, and provision for impairment in the value of investments." }, { "section_name": "", "short_title": "Review of Emphasis of Matter (EOM) Paragraph in Auditor's Report", "action_item": "Review the Auditor's Report to check if an Emphasis of Matter (EOM) paragraph has been included, and verify if the EOM is justified and in accordance with the disclosure requirements as per the Standards of Auditing (SAs)." }, { "section_name": "", "short_title": "Calculation of Profit Before Tax", "action_item": "Recalculate the Profit Before Tax to verify if it has been accurately reported, taking into account the reversal of General Contingency Provision, valuation of derivative assets, and provision for impairment in the value of investments." } ]

[ { "section_name": "", "short_title": "Review Going Concern Assumption", "action_item": "Review the assessment of the use of the Going Concern assumption by the management to verify its accuracy and compliance with relevant standards." }, { "section_name": "", "short_title": "Verify Communication with Governance", "action_item": "Verify that complete and required communication has taken place with Those Charged With Governance as per the standards and regulations." }, { "section_name": "", "short_title": "Evaluate Risk of Material Misstatements", "action_item": "Check the evaluation of the Risk of Material Misstatements to ensure it is adequate and proper, and compliant with relevant standards and regulations." }, { "section_name": "", "short_title": "Review Materiality Amounts", "action_item": "Review the determination of Materiality amounts to verify that they are based on relevant factors and compliant with standards and regulations." }, { "section_name": "", "short_title": "Assess Engagement Quality Control Review", "action_item": "Assess the Engagement Quality Control Review (EQCR) mechanism to verify that it is adequate for the intended task and compliant with relevant standards and regulations." }, { "section_name": "", "short_title": "Evaluate IT Processes and Platform", "action_item": "Evaluate the IT processes and platform used for Audit File documentation to identify any deficiencies, particularly in relation to basic principles of IT security, and verify that they are fit for the intended purpose." } ]

[ { "section_name": "Definitions.", "short_title": "Review Definitions", "action_item": "Review the definitions provided in the Regulations to understand the meaning of key terms such as 'Code', 'control', 'certificate of registration', and 'net worth' as defined in the context of these Regulations and relevant Acts." }, { "section_name": "Definitions.", "short_title": "Verify Code Reference", "action_item": "Verify that the 'Code' refers to the Insolvency and Bankruptcy Code, 2016, as defined in the Regulations." }, { "section_name": "Definitions.", "short_title": "Check Control Definition", "action_item": "Check that the definition of 'control' is consistent with the meaning assigned to it in section 2(27) of the Companies Act, 2013." }, { "section_name": "Definitions.", "short_title": "Verify Certificate of Registration", "action_item": "Verify that the 'certificate of registration' means a certificate granted or renewed by the Board under these Regulations." }, { "section_name": "Definitions.", "short_title": "Review Net Worth Definition", "action_item": "Review that the 'net worth' has the same meaning as assigned to it under section 2(57) of the Companies Act, 2013." }, { "section_name": "Definitions.", "short_title": "Check Default Meaning of Terms", "action_item": "Check that words and expressions used but not defined in these Regulations have the meanings assigned to them in the Code, unless the context otherwise requires." } ]

[ { "section_name": "", "short_title": "Review Registration Undertaking", "action_item": "Review the registration undertaking to verify that it includes a commitment to comply with the requirements of the Code, rules, regulations, guidelines, and other conditions and terms as specified in the certificate of registration or imposed by the Board." }, { "section_name": "", "short_title": "Verify Certificate of Registration", "action_item": "Verify that the certificate of registration contains all the necessary conditions and terms that the organization must comply with." }, { "section_name": "", "short_title": "Check Compliance with Code and Regulations", "action_item": "Check that the organization is complying with the requirements of the Code, rules, regulations, and guidelines issued thereunder." }, { "section_name": "", "short_title": "Review Subsequent Conditions and Terms", "action_item": "Review any subsequent conditions and terms specified or imposed by the Board to verify that the organization is aware of and complying with them." }, { "section_name": "", "short_title": "Authenticate Authorized Signatory", "action_item": "Verify the authenticity of the authorized signatory's signature, name, designation, and date on the registration undertaking." }, { "section_name": "ANNEXURE TO FORM A PART I GENERAL", "short_title": "Verify Applicant Information", "action_item": "Review and verify the name of the applicant as provided in the application." }, { "section_name": "ANNEXURE TO FORM A PART I GENERAL", "short_title": "Verify Registered Office Address", "action_item": "Check and verify the address of the registered office of the applicant as provided in the application." }, { "section_name": "ANNEXURE TO FORM A PART I GENERAL", "short_title": "Verify Principal Place of Business", "action_item": "Verify the principal place of business of the applicant as provided in the application." }, { "section_name": "ANNEXURE TO FORM A PART I GENERAL", "short_title": "Verify Corporate Identification Number (CIN)", "action_item": "Review and verify the Corporate Identification Number (CIN) of the applicant as provided in the application." }, { "section_name": "ANNEXURE TO FORM A PART I GENERAL", "short_title": "Verify PAN", "action_item": "Check and verify the PAN of the applicant as provided in the application." }, { "section_name": "ANNEXURE TO FORM A PART I GENERAL", "short_title": "Verify Authorized Person Details", "action_item": "Review and verify the name, designation, and contact details of the person authorized to make this application and correspond with the Board." } ]

[ { "section_name": "PART II MEMORANDUM OF ASSOCIATION, ARTICLES OF ASSOCIATION AND BYELAWS", "short_title": "Review Memorandum and Articles of Association", "action_item": "Review the memorandum of association, articles of association, and bye-laws to verify that they provide for all matters as required in, and are consistent with the Insolvency and Bankruptcy Board of India (Model Bye-Laws and Governing Board of Insolvency Professional Agencies) Regulations, 2016, and the Insolvency and Bankruptcy Board of India (Insolvency Professional Agencies) Regulations, 2016." }, { "section_name": "PART II MEMORANDUM OF ASSOCIATION, ARTICLES OF ASSOCIATION AND BYELAWS", "short_title": "Verify Additional Bye-Law Provisions", "action_item": "Check if there are any provisions in the bye-laws that are in addition to the provisions of the model bye-laws specified in the Insolvency and Bankruptcy Board of India (Model Bye-Laws and Governing Board of Insolvency Professional Agencies) Regulations, 2016, and if so, verify the clause numbers of these additional provisions." }, { "section_name": "PART III SHAREHOLDING AND FINANCIAL STRENGTH", "short_title": "Review Shareholding Details", "action_item": "Review the details of persons holding more than 5% of the share capital of the applicant, including those holding shares directly or indirectly, to verify compliance with regulatory requirements." }, { "section_name": "PART III SHAREHOLDING AND FINANCIAL STRENGTH", "short_title": "Verify Foreign Shareholding", "action_item": "Verify whether persons resident outside India hold more than 49% of the share capital of the applicant and review the provided details to assess compliance with foreign shareholding limits." }, { "section_name": "PART III SHAREHOLDING AND FINANCIAL STRENGTH", "short_title": "Identify Control Over Applicant", "action_item": "Check who exercises control over the applicant and review the provided details to understand the control structure and verify compliance with regulatory requirements." }, { "section_name": "PART III SHAREHOLDING AND FINANCIAL STRENGTH", "short_title": "Assess Foreign Control Over Management", "action_item": "Determine if persons resident outside India exercise control over the management or policy decisions of the applicant, and if so, review the provided details to evaluate compliance with foreign control regulations." }, { "section_name": "PART III SHAREHOLDING AND FINANCIAL STRENGTH", "short_title": "Review Audited Financial Statements", "action_item": "Review the audited financial statements of the last three years (or from the date of incorporation, if less) for the following entities: (a) any company holding more than 10% of the share capital of the applicant, (b) any company in control of the applicant, (c) the promoter company (if any), and (d) the applicant itself, to verify financial strength and compliance with regulatory requirements." } ]

[ { "section_name": "", "short_title": "Review Share Capital Holders", "action_item": "Review the information provided to demonstrate that persons holding more than 5% of the share capital of the company are fit and proper persons, including their background and any other relevant details." }, { "section_name": "", "short_title": "Verify Promoters' Fitness", "action_item": "Verify the information provided to demonstrate that the promoters of the company are fit and proper persons, including their background, experience, and any other relevant details." }, { "section_name": "", "short_title": "Check Additional Information", "action_item": "Check if any additional information has been provided to support the fitness and propriety of persons holding more than 5% of the share capital and the promoters, and review its relevance and adequacy." } ]

[ { "section_name": "SCHEDULE FORM B", "short_title": "Verify Certificate of Registration", "action_item": "Review the certificate of registration to verify that it has been granted or renewed by the Insolvency and Bankruptcy Board of India, and check that it includes the name and address of the insolvency professional agency, the start and end dates of validity, and the signature of the authorized representative." }, { "section_name": "SCHEDULE FORM B", "short_title": "Check Validity Period", "action_item": "Verify the validity period of the certificate of registration, including the start and end dates, to ensure it is current and has not expired." }, { "section_name": "SCHEDULE FORM B", "short_title": "Confirm Authorization", "action_item": "Check that the certificate of registration is signed by the authorized representative, Dr. M. S. Sahoo, Chairperson of the Insolvency and Bankruptcy Board of India, or another duly authorized person." } ]

[ { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Verify Company Registration", "action_item": "Review and verify that the insolvency professional agency is a company registered under section 8 of the Companies Act, 2013." }, { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Check Sole Object", "action_item": "Verify that the sole object of the company is to carry on the functions of an insolvency professional agency under the Code." }, { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Review Bye-Laws and Governance Structure", "action_item": "Check and verify that the company has bye-laws and governance structure in accordance with the Insolvency and Bankruptcy Board of India (Model Bye-Laws and Governing Board of Insolvency Professional Agencies) Regulations, 2016." }, { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Verify Minimum Net Worth", "action_item": "Review and verify that the company has a minimum net worth of ten crore rupees." }, { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Check Paid-Up Share Capital", "action_item": "Verify that the company has a paid-up share capital of five crore rupees." }, { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Verify Control and Shareholding", "action_item": "Check and verify that the company is not under the control of any person resident outside India and not more than forty-nine per cent of its share capital is held, directly or indirectly, by persons resident outside India." }, { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Check Subsidiary Status", "action_item": "Verify that the company is not a subsidiary of a body corporate through more than one layer." }, { "section_name": "CHAPTER II REGISTRATION 2[3. Eligibility for registration. –", "short_title": "Assess Fit and Proper Persons", "action_item": "Review and verify that the applicant, its promoters, its directors, and its shareholders are fit and proper persons." } ]

[ { "section_name": "", "short_title": "Review Acknowledgement Timeline", "action_item": "Review the application acknowledgement process to verify that the Board acknowledges an application within seven days of its receipt." }, { "section_name": "", "short_title": "Verify Examination Process", "action_item": "Verify that the Board examines the application and provides an opportunity to the applicant to remove any deficiencies in the application." }, { "section_name": "", "short_title": "Check Additional Document Requests", "action_item": "Check if the Board requires the applicant to submit additional documents, information, or clarification within a reasonable time frame, and verify that such requests are properly documented." }, { "section_name": "", "short_title": "Review Applicant Appearance Requirements", "action_item": "Review the process to verify that the Board requires the applicant to appear before the Board in person or through an authorized representative for clarifications, and that such appearances are scheduled within a reasonable time frame." } ]

[ { "section_name": "", "short_title": "Review Communication Timeline", "action_item": "Review the communication made to the applicant to verify that it was made within forty five days of receipt of the application, excluding the time given by the Board for removing deficiencies, presenting additional documents, information or clarifications, or appearing in person." }, { "section_name": "", "short_title": "Verify Decision Communication", "action_item": "Verify that the Board's decision to accept or reject the application was communicated to the applicant within thirty days of receipt of explanation, along with the certificate of registration for accepted applications or reasons for rejection for rejected applications." }, { "section_name": "", "short_title": "Check Order for Renewal Rejection", "action_item": "Check that the order rejecting an application for renewal of registration includes requirements for the insolvency professional agency to discharge pending obligations." }, { "section_name": "", "short_title": "Verify Continuation of Functions", "action_item": "Verify that the order rejecting an application for renewal of registration includes a requirement for the insolvency professional agency to continue its functions till such time as may be specified, to enable the enrolment of its members with another insolvency professional agency." }, { "section_name": "", "short_title": "Review Compliance with Directions", "action_item": "Review the order rejecting an application for renewal of registration to verify that it includes any other directions considered appropriate by the Board and check that the insolvency professional agency complies with these directions." }, { "section_name": "CHAPTER IIISURRENDER OR CANCELLATION OF REGISTRATION7. Surrender of registration.", "short_title": "Review Surrender Application", "action_item": "Review the application for surrender of a certificate of registration submitted by an insolvency professional agency to verify that it includes the reasons for such surrender." }, { "section_name": "CHAPTER IIISURRENDER OR CANCELLATION OF REGISTRATION7. Surrender of registration.", "short_title": "Verify Pending Engagements", "action_item": "Verify that the application for surrender of a certificate of registration includes the details of all pending or on-going engagements under the Code of the insolvency professionals enrolled with the agency." }, { "section_name": "CHAPTER IIISURRENDER OR CANCELLATION OF REGISTRATION7. Surrender of registration.", "short_title": "Check Pending Activities", "action_item": "Check that the application for surrender of a certificate of registration includes details of the agency's pending or on-going activities." }, { "section_name": "CHAPTER IIISURRENDER OR CANCELLATION OF REGISTRATION7. Surrender of registration.", "short_title": "Review Wind-up Plan", "action_item": "Review the manner in which the insolvency professional agency seeks to wind-up its affairs as stated in the application for surrender of a certificate of registration." } ]

[ { "section_name": "", "short_title": "Review Publication of Notice", "action_item": "Review the Board's website to verify that a notice of receipt of the application for surrender of registration is published within seven days of receipt of the application." }, { "section_name": "", "short_title": "Verify Objection Period", "action_item": "Verify that the notice published on the Board's website invites objections to the surrender of registration and that the objections are to be submitted within fourteen days of the publication of the notice." }, { "section_name": "", "short_title": "Check Approval Timeline", "action_item": "Check that the Board approves the application for surrender of registration within thirty days from the last date of submission of objections, if any." }, { "section_name": "", "short_title": "Review Conditions for Approval", "action_item": "Review the conditions, if any, imposed by the Board while approving the application for surrender of registration." }, { "section_name": "", "short_title": "Verify Discharge of Obligations", "action_item": "Verify that the insolvency professional agency has discharged any pending obligations as required by the Board's approval." }, { "section_name": "", "short_title": "Check Continuation of Functions", "action_item": "Check if the insolvency professional agency is required to continue its functions till a specified time to enable the enrolment of its members with another insolvency professional agency, and verify compliance with this requirement." }, { "section_name": "", "short_title": "Review Publication of Surrender Notice", "action_item": "Review the Board's website to verify that a notice stating that the surrender of registration by the insolvency professional agency has taken effect is published after the Board is satisfied that the requirements have been complied with." }, { "section_name": "8. Disciplinary proceedings.", "short_title": "Review Show-Cause Notice Issuance", "action_item": "Review if the Board issues a show-cause notice to the insolvency professional agency based on the findings of an inspection or investigation, or on material otherwise available on record, when it is of the prima facie opinion that sufficient cause exists to take actions permissible under section 220." }, { "section_name": "8. Disciplinary proceedings.", "short_title": "Verify Show-Cause Notice Content", "action_item": "Verify that the show-cause notice is in writing and includes the following: (a) the provisions of the Code under which it has been issued, (b) the details of the alleged facts, (c) the details of the evidence in support of the alleged facts, (d) the provisions of the Code, rules, regulations or guidelines thereunder allegedly violated, or the manner in which the public interest is allegedly affected, (e) the actions or directions that the Board proposes to take or issue if the allegations are established, and (f) the manner in which the insolvency professional agency is required to respond to the show-cause notice." }, { "section_name": "8. Disciplinary proceedings.", "short_title": "Check Show-Cause Notice Response", "action_item": "Check if the insolvency professional agency responds to the show-cause notice in the manner specified by the Board, and verify that the response addresses all the allegations and provisions mentioned in the notice." } ]

[ { "section_name": "", "short_title": "Review Order Effective Date", "action_item": "Review the order passed under sub-regulation (10) to verify that it does not become effective until thirty days have elapsed from the date of issue, unless the Disciplinary Committee has stated otherwise in the order with a valid reason." }, { "section_name": "", "short_title": "Verify Order Issuance and Publication", "action_item": "Verify that the order passed under sub-regulation (10) is issued to the insolvency professional agency immediately and published on the website of the Board." }, { "section_name": "", "short_title": "Check Suspension or Cancellation of Registration", "action_item": "Check if the order passed under sub-regulation (10) suspends or cancels the registration of the insolvency professional agency, and if so, verify that the Disciplinary Committee has required the agency to discharge pending obligations." }, { "section_name": "", "short_title": "Verify Continuation of Functions", "action_item": "Verify that if the order suspends or cancels the registration, the insolvency professional agency is required to continue its functions until a specified time to enable the enrolment of its members with another insolvency professional agency." }, { "section_name": "", "short_title": "Review Compliance with Directions", "action_item": "Review the order to verify that the insolvency professional agency is required to comply with any other directions considered appropriate by the Disciplinary Committee in the event of suspension or cancellation of registration." }, { "section_name": "9. Appeal.", "short_title": "Review Appeal Filing Period", "action_item": "Review the time period within which an appeal is filed under section 202 of the Code to verify that it does not exceed thirty days from the receipt of the impugned order." }, { "section_name": "9. Appeal.", "short_title": "Verify Appeal Filing Procedure", "action_item": "Verify that the appeal is filed in the manner prescribed in Part III of the National Company Law Tribunal Rules, 2016." }, { "section_name": "9. Appeal.", "short_title": "Check Receipt of Impugned Order", "action_item": "Check the documentation to confirm the date of receipt of the impugned order, which serves as the starting point for the thirty-day appeal period." } ]

[ { "section_name": "", "short_title": "Verify In-Principle Approval Application", "action_item": "Review the company's application for a certificate of registration as an insolvency professional agency to the Board, and verify that it is made in accordance with Regulation 4(1) during the validity of the in-principle approval." }, { "section_name": "", "short_title": "Check Application Fee Exemption", "action_item": "Verify that the company is not required to pay the application fees for registration as an insolvency professional agency during the validity of the in-principle approval, as per the given regulation." }, { "section_name": "", "short_title": "Confirm Regulation Compliance", "action_item": "Check that the company's application for a certificate of registration as an insolvency professional agency complies with the requirements of Regulation 4(1) and sub-regulation 2(b)." }, { "section_name": "APPLICATION FOR CERTIFICATE OF REGISTRATION", "short_title": "Verify Application Address", "action_item": "Review the application to verify that it is addressed to the correct recipient, specifically the Chairperson of the Insolvency and Bankruptcy Board of India, at the correct address." }, { "section_name": "APPLICATION FOR CERTIFICATE OF REGISTRATION", "short_title": "Check Application Sender Details", "action_item": "Verify that the application includes the name and address of the sender, which should be the entity applying for the grant or renewal of the certificate of registration as an insolvency professional agency." }, { "section_name": "APPLICATION FOR CERTIFICATE OF REGISTRATION", "short_title": "Confirm Application Purpose", "action_item": "Check that the application clearly states its purpose, which is for the grant or renewal of a certificate of registration as an insolvency professional agency under Regulation 4 of the Insolvency and Bankruptcy Board of India (Insolvency Professional Agencies) Regulations, 2016." } ]

[]

[ { "section_name": "5. बीमाकताचओं द्वारा बीमा एिेंटों, मध्यिर्तचयों या बीमा मध्यिर्तचयों को देय कमीिि", "short_title": "Review Management Expenses for Life Insurance Companies", "action_item": "Review the management expenses of life insurance companies to verify that the total commission payable on life insurance products does not exceed the prescribed limits set by the IRDAI (Insurance Regulatory and Development Authority of India) under the Insurance Regulatory and Development Authority of India (Expenses of Management of Insurers carrying on Life Insurance Business) Regulations, 2023." }, { "section_name": "5. बीमाकताचओं द्वारा बीमा एिेंटों, मध्यिर्तचयों या बीमा मध्यिर्तचयों को देय कमीिि", "short_title": "Verify Compliance for General and Standalone Health Insurance Companies", "action_item": "Verify that the total commission payable on general insurance products and standalone health insurance products by general insurance companies and standalone health insurance companies, respectively, does not exceed the limits prescribed by the IRDAI under the Insurance Regulatory and Development Authority of India (Expenses of Management of Insurers carrying on General or Health Insurance Business) Regulations, 2023." }, { "section_name": "5. बीमाकताचओं द्वारा बीमा एिेंटों, मध्यिर्तचयों या बीमा मध्यिर्तचयों को देय कमीिि", "short_title": "Check for Adherence to IRDAI Regulations", "action_item": "Check that the insurance companies are adhering to the IRDAI regulations regarding management expenses, specifically ensuring that the expenses are within the prescribed limits and are in compliance with the IRDAI (Expenses of Management of Insurers) Regulations, 2023." } ]

[]

[ { "section_name": "", "short_title": "Verify Commission Payable Limits", "action_item": "Review the total amount of commission payable under general insurance products, including health insurance products offered by general insurers and standalone health insurers, to verify that it does not exceed the Expenses of Management (EOM) limits specified under the Insurance Regulatory and Development Authority of India (Expenses of Management of Insurers transacting General or Health Insurance business) Regulations, 2023, as amended from time to time." }, { "section_name": "", "short_title": "Check Regulatory Compliance", "action_item": "Check the Insurance Regulatory and Development Authority of India (Expenses of Management of Insurers transacting General or Health Insurance business) Regulations, 2023, for any amendments and verify that the organization is in compliance with the latest regulations regarding commission payable limits." }, { "section_name": "6. Submission of Returns on payment of Commission by the insurer", "short_title": "Review Submission of Returns", "action_item": "Review that all insurers submit to the Authority the Board approved returns on payment of commission by the insurer to the Insurance agent, Intermediary or Insurance intermediary within 45 days of the expiration of each financial year." }, { "section_name": "6. Submission of Returns on payment of Commission by the insurer", "short_title": "Verify Return Formats", "action_item": "Verify that the formats for submitting information and data on payment of commission by the insurer are as specified by the Authority from time to time." }, { "section_name": "6. Submission of Returns on payment of Commission by the insurer", "short_title": "Check Audit Committee Review", "action_item": "Check that the returns on payment of commission by the insurer are reviewed by the Audit Committee prior to being placed for approval of the Board of the insurer." } ]

[ { "section_name": "Che Gazette of Jndia vlk/kj.k", "short_title": "Review Section 2(ख)(i) Compliance", "action_item": "Review and verify that the organization complies with the requirements stated in section 2(ख)(i) 'राEय मं ी, आ थ क काय ि', and check that all relevant procedures are in place and followed." }, { "section_name": "Che Gazette of Jndia vlk/kj.k", "short_title": "Verify Section 2(ख)(ii) Adherence", "action_item": "Verify that the organization adheres to the guidelines outlined in section 2(ख)(ii) 'गवन र, भारतीय बFक (आ', and confirm that all necessary documentation is maintained." }, { "section_name": "Che Gazette of Jndia vlk/kj.k", "short_title": "Check Section 2(ख)(iii) Compliance", "action_item": "Check and confirm that the organization is in compliance with the regulations stated in section 2(ख)(iii) 'िव सिचव और/या सिचव, आ थ', and review that all processes are aligned with these requirements." }, { "section_name": "Che Gazette of Jndia vlk/kj.k", "short_title": "Review Section 2(ख)(iv) Adherence", "action_item": "Review and verify that the organization adheres to the requirements outlined in section 2(ख)(iv) 'सिचव, राज)व िवभाग', and ensure that all relevant records are properly kept." }, { "section_name": "Che Gazette of Jndia vlk/kj.k", "short_title": "Verify Section 2(ख)(v) Compliance", "action_item": "Verify that the organization complies with the guidelines stated in section 2(ख)(v) 'सिचव, िव ीय सेवाएं िवभाग', and confirm that all necessary procedures are in place and followed." }, { "section_name": "Che Gazette of Jndia vlk/kj.k", "short_title": "Check Section 2(ख)(vi) Adherence", "action_item": "Check and confirm that the organization adheres to the requirements outlined in section 2(ख)(vi) 'सिचव, कारपोरेट काय मं ालय'', and review that all processes are aligned with these requirements." } ]

[ { "section_name": "", "short_title": "Review Notification Amendments", "action_item": "Review the amendments made in the notification of the Government of India, Ministry of Finance, Department of Economic Affairs, F.No. 14/33/2010-EM dated 30th December, 2010, as amended vide notifications of even number dated 6th August, 2013, 5th December, 2013, and 18th September 2017." }, { "section_name": "", "short_title": "Verify Substitutions in Para 2(b)", "action_item": "Verify that the following substitutions have been made in the said notification for para 2(b)(i) to para 2(b)(ix): 2(b)(i) 'Minister of State, in-charge of Department of Economic Affairs', 2(b)(ii) 'Governor, Reserve Bank of India (RBI)', 2(b)(iii) 'Finance Secretary and/ or Secretary, Department of Economic Affairs', 2(b)(iv) 'Secretary, Department of Revenue', 2(b)(v) 'Secretary, Department of Financial Services', 2(b)(vi) 'Secretary, Ministry of Corporate Affairs', 2(b)(vii) 'Secretary, Ministry of Electronics and Information Technology', 2(b)(viii) 'Chief Economic Adviser, Ministry of Finance', 2(b)(ix) 'Chairperson, Securities and Exchange Board of India (SEBI)'." }, { "section_name": "", "short_title": "Check Additional Substitutions", "action_item": "Check if the following additional substitutions have been made: 2(b)(x) 'Chairperson, Insurance Regulatory and Development Authority of India (IRDAI)', 2(b)(xi) 'Chairperson, Pension Fund Regulatory and Development Authority (PFRDA)', 2(b)(xii) 'Chairperson, Insolvency and Bankruptcy Board of India (IBBI)'." }, { "section_name": "", "short_title": "Confirm Principal Notification", "action_item": "Confirm that the principal notification was published in the Gazette of India, Extraordinary Part I-Section 1, vide F.No. 14/33/2010-EM, dated the 30th December, 2010." }, { "section_name": "", "short_title": "Verify Amendment Dates", "action_item": "Verify the dates of subsequent amendments: 6th August, 2013, 5th December 2013, and 18th September 2017, vide notifications F.No. 18/14/2013-FSDC." } ]

[ { "section_name": "Insolvency and Bankruptcy Board of India 7th Floor, Mayur Bhawan, Connaught Place, New Delhi-110001", "short_title": "Review Circular Compliance", "action_item": "Review the compliance status of the organization with respect to the circular no. IBBI/LIQ/61/2023 dated 28th September 2023, specifically the remaining parts of the circular after the withdrawal of paras 2.1 and 2.5." }, { "section_name": "Insolvency and Bankruptcy Board of India 7th Floor, Mayur Bhawan, Connaught Place, New Delhi-110001", "short_title": "Verify Submission of Compliance", "action_item": "Verify if the organization has submitted any compliance in relation to the circular dated 28th September 2023, and if not, check if the opportunity to comply with the remaining parts of the circular has been utilized." }, { "section_name": "Insolvency and Bankruptcy Board of India 7th Floor, Mayur Bhawan, Connaught Place, New Delhi-110001", "short_title": "Check Electronic Submission", "action_item": "Check if the status of compliance with the remaining parts of the circular dated 28th September 2023 has been informed to the IBBI electronically on the website of IBBI on or before 31st May 2024." }, { "section_name": "Insolvency and Bankruptcy Board of India 7th Floor, Mayur Bhawan, Connaught Place, New Delhi-110001", "short_title": "Review Calculation of Fee", "action_item": "Review the calculation of the liquidator's fee to ensure it is in accordance with the modified circular, considering the withdrawal of paras 2.1 and 2.5." }, { "section_name": "Insolvency and Bankruptcy Board of India 7th Floor, Mayur Bhawan, Connaught Place, New Delhi-110001", "short_title": "Verify Regulatory Compliance", "action_item": "Verify that the organization is complying with the Insolvency and Bankruptcy Code, 2016, specifically section 196, and the IBBI (Liquidation Process) Regulations, 2016, as amended." } ]

[ { "section_name": "Based on the", "short_title": "Review SCN Issuance", "action_item": "Review the Show Cause Notice (SCN) dated 1st May 2020 to verify that it was issued in accordance with the provisions of IRDAI (TPA-Health Services) Regulations, 2016, and that it correctly identifies the observed deficiencies in complying with the TPA Regulations by M/s. Anyuta Insurance TPA In Health Care Pvt. Ltd." }, { "section_name": "Based on the", "short_title": "Verify TPA Response", "action_item": "Verify the response to the SCN made by the TPA in their written replies vide letter dated 09th May 2020, and check that it was forwarded by email on 10th May 2020, to ensure the TPA's response is properly documented and timely." }, { "section_name": "Based on the", "short_title": "Check Personal Hearing Submissions", "action_item": "Check the submissions made during the Personal Hearing chaired by Ms. T.L. Alamelu, Member (Non-Life), on 29th May 2020 at 1500 hrs. through Video Conference by Skype, to verify that all relevant points were addressed and that the hearing was conducted in accordance with the regulatory requirements." }, { "section_name": "Based on the", "short_title": "Confirm Regulatory Compliance", "action_item": "Confirm that M/s. Anyuta Insurance TPA In Health Care Pvt. Ltd. has complied with the provisions of IRDAI (TPA-Health Services) Regulations, 2016, as stated in the SCN and subsequent responses, by reviewing all relevant documentation and evidence." }, { "section_name": "Background", "short_title": "Review Certificate of Registration", "action_item": "Review the certificate of registration No.17 granted to M/s Anyuta TPA on 16th May 2002 and verify its renewal status." }, { "section_name": "Background", "short_title": "Verify Renewal Application", "action_item": "Check the renewal application filed by the TPA on BAP ref: TPA-566-2020 dated 15th April 2020 and verify that it was submitted prior to the renewal due date of 16th May 2020." }, { "section_name": "Background", "short_title": "Examine Compliance with Minimum Business Requirements", "action_item": "Examine the renewal application and verify that the TPA complies with the minimum business requirements stipulated under Annexure-11 of Circular Ref: IRDA/TPA/REG/CIR/059/03/2016 dated 28th March 2016 read with Regulation 14 of IRDAI (TPA-Health Services) Regulations, 2016." }, { "section_name": "Background", "short_title": "Verify Regulation 14 Compliance", "action_item": "Review Regulation 14 of IRDAI (TPA-Health Services) Regulations, 2016 and verify that the TPA is in compliance with the minimum business requirements stipulated therein." }, { "section_name": "Background", "short_title": "Check for Violations", "action_item": "Check if the TPA is in violation of the minimum business requirements as stipulated in Regulation 14 of IRDAI (TPA-HS) Regulations, 2016 and document any non-compliances." }, { "section_name": "a.“14.MinimumBusiness Requirements:", "short_title": "Verify TPA Registration Compliance", "action_item": "Review and verify that every Third-Party Administrator (TPA) registered with the Authority complies with the minimum business requirements specified by the Authority towards health services for insurers registered with the Authority." }, { "section_name": "a.“14.MinimumBusiness Requirements:", "short_title": "Check Minimum Business Norms", "action_item": "Check and confirm that the minimum business norms specified by the Authority are being followed by the TPA, including any updates or changes made by the Authority from time to time." }, { "section_name": "a.“14.MinimumBusiness Requirements:", "short_title": "Confirm Effective Date of Compliance", "action_item": "Verify that the TPA is complying with the minimum business requirements with effect from the date specified by the Authority." } ]

[]

[ { "section_name": "", "short_title": "Review TPA Registration Renewal", "action_item": "Review the registration renewal of the Third Party Administrator (TPA) to verify that it has not been renewed if the TPA has failed to comply with Regulation 15(c)(6)(a) or 15(c)(6)(b) of TPA regulations." }, { "section_name": "", "short_title": "Verify Show Cause Notice", "action_item": "Verify that a show cause notice was issued to the TPA, as required, when the TPA failed to comply with the relevant regulations, and check the notice's date and content for accuracy." }, { "section_name": "", "short_title": "Check TPA Response to SCN", "action_item": "Check that the TPA submitted a response to the show cause notice, and verify the date and method of submission (e.g., email, letter) to ensure it was done in a timely and appropriate manner." }, { "section_name": "", "short_title": "Review Personal Hearing Details", "action_item": "Review the details of the personal hearing, including the date, time, method (e.g., video conference), and the individuals present, to verify that it was conducted fairly and in accordance with the regulations." }, { "section_name": "", "short_title": "Examine Findings and Decisions", "action_item": "Examine the findings on the submissions made by the TPA and the decisions taken thereafter to verify that they are based on the issues raised in the show cause notice and are in compliance with the relevant regulations." }, { "section_name": "Charge:", "short_title": "Review Compliance with Regulation 14", "action_item": "Review the TPA's business requirements to verify compliance with the minimum requirements specified under Regulation 14 of IRDAl (TPA-Health Services) Regulations, 2016, and check if the TPA has implemented these requirements as mandated." }, { "section_name": "Charge:", "short_title": "Verify IRDAl Regulation Documentation", "action_item": "Verify that the TPA has the necessary documentation to support compliance with Regulation 14 of IRDAl (TPA-Health Services) Regulations, 2016, including records of implementation and any relevant certifications or approvals." }, { "section_name": "Charge:", "short_title": "Check for Non-Compliance Records", "action_item": "Check for any records or instances of non-compliance with Regulation 14 of IRDAl (TPA-Health Services) Regulations, 2016, and review the TPA's procedures for addressing and rectifying such instances." }, { "section_name": "Gist of TPA's submissions:", "short_title": "Review Empanelment Status", "action_item": "Review the status of empanelment with Insurance Companies to verify if the organization has been successful in getting empanelled." }, { "section_name": "Gist of TPA's submissions:", "short_title": "Verify Application to Insurance Companies", "action_item": "Verify that applications have been submitted to all Insurance Companies to request empanelment and allocation of business." }, { "section_name": "Gist of TPA's submissions:", "short_title": "Check Response from Insurance Companies", "action_item": "Check if there have been any responses from Insurance Companies regarding the applications for empanelment and allocation of business." }, { "section_name": "Gist of TPA's submissions:", "short_title": "Assess Compliance with IRDAI Regulations", "action_item": "Assess whether the organization's current situation regarding empanelment and business allocation complies with IRDAI regulations, specifically considering the option for insured individuals to choose a TPA from IRDAI-licensed TPAs." }, { "section_name": "Gist of TPA's submissions:", "short_title": "Evaluate Minimum Business Requirement", "action_item": "Evaluate the relevance of the minimum business requirement in the context of IRDAI regulations and the organization's situation, considering the potential for automatic allocation if insured individuals can choose from all IRDAI-licensed TPAs." } ]

[ { "section_name": "", "short_title": "Review TPA Registration Certificate", "action_item": "Review the certificate of registration of the Third Party Administrator (TPA) to verify the date of registration and the period of operation in the industry." }, { "section_name": "", "short_title": "Verify Business Activity", "action_item": "Verify if the TPA has done any business in the preceding three years as specified under regulation 14 of IRDAl (TPA-HS) Regulations, 2016 and the Minimum Business norms as stipulated under Annexure-11 of Circular Ref: IRDA/TPA/REG/CIR/059/03/2016." }, { "section_name": "", "short_title": "Check Empanelment Status", "action_item": "Check if the TPA has been empaneled with any of the insurers." }, { "section_name": "", "short_title": "Review Renewal Application", "action_item": "Review the renewal application of the TPA to verify if it meets the requirements of Regulation 16(1)(f) to be read with Reg.15(C)(6)(c) of IRDAl (Third Party Administrators-Health Services) Regulations, 2016." }, { "section_name": "", "short_title": "Verify Compliance with Directions", "action_item": "Verify that the TPA has complied with the directions given in the event of rejection of the renewal application, including removing the word 'TPA' from the company name." }, { "section_name": "", "short_title": "Check Alternative Arrangements", "action_item": "Verify that the insurers who had a TPA agreement with the rejected TPA have taken alternative steps, including the appointment of another TPA, to continue catering to the policyholders served by the rejected TPA." }, { "section_name": "", "short_title": "Review Data Submission", "action_item": "Verify that the rejected TPA has submitted the data collected and the books, records, or documents related to the TPA business to the respective insurers." }, { "section_name": "", "short_title": "Check Cooperation with Insurers", "action_item": "Verify that the rejected TPA is cooperating with the insurance companies in making suitable alternate arrangements to service the policyholders in respect of whom the policies are in force." }, { "section_name": "", "short_title": "Review Account Reconciliation", "action_item": "Verify that the rejected TPA has reconciled and closed the accounts with the concerned insurance companies and network providers, if any." } ]

[ { "section_name": "ALL GENERAL INSURERS(EXCEPT ECGC, AIC AND STAND-ALONE HEALTH INSURERS)", "short_title": "Review CPA Policy Offerings", "action_item": "Review the insurer's policy offerings to verify that they provide the option for a one-year Compulsory Personal Accident (CPA) cover to owner-drivers, in addition to long-term CPA cover, and that owner-drivers are not compelled to opt for a long-term package policy or long-term CPA cover." }, { "section_name": "ALL GENERAL INSURERS(EXCEPT ECGC, AIC AND STAND-ALONE HEALTH INSURERS)", "short_title": "Verify Eligibility for Compulsory PA Cover", "action_item": "Verify that the insurer is applying the eligibility criteria for Compulsory Personal Accident (PA) cover correctly, specifically that it is only applicable to registered owners who hold a valid driving licence, and not to vehicles owned by companies, partnership firms, or similar bodies corporate, or to owner-drivers without a valid driving licence." }, { "section_name": "ALL GENERAL INSURERS(EXCEPT ECGC, AIC AND STAND-ALONE HEALTH INSURERS)", "short_title": "Confirm Compliance with Regulations", "action_item": "Confirm that the insurer is complying with the regulatory requirements regarding the offering of Compulsory Personal Accident Insurance for owner-drivers, including providing the choice of a one-year CPA cover and applying the correct eligibility criteria for Compulsory PA cover." } ]

[ { "section_name": "INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY Ref:66/CA/INSP/NL/JAN2011", "short_title": "Review Claim Servicing Compliance", "action_item": "Review the company's claim servicing processes to verify adherence to IRDA PPHI Regulations 2002, specifically Regulation 9(1) and Regulation 9(5), to ensure timely response to insured post-claim intimation and offer of claim settlement." }, { "section_name": "INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY Ref:66/CA/INSP/NL/JAN2011", "short_title": "Verify Claim Settlement Delays", "action_item": "Verify that the company has implemented measures to prevent delays in settling claims under Property/Fire Insurance Policies, as per the complaint regarding M/s. J.B. Handloom Centre (Complaint No. 4/OIC/COMP/10-11)." }, { "section_name": "INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY Ref:66/CA/INSP/NL/JAN2011", "short_title": "Check Acknowledgement of Regulatory Letters", "action_item": "Check if the company has acknowledged receipt of regulatory letters, such as the one dated February 26, 2013, regarding inspection of complaints and compliance with IRDA regulations." }, { "section_name": "INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY Ref:66/CA/INSP/NL/JAN2011", "short_title": "Examine Compliance with IRDA Regulations", "action_item": "Examine the company's compliance with IRDA PPHI Regulations 2002 in all matters related to claim servicing, and verify that the company has taken necessary steps to avoid similar violations in the future." } ]

[ { "section_name": "", "short_title": "Review Effective Date of Bankruptcy Code Provisions", "action_item": "Review and verify that the provisions of sections 59, 209 to 215 (inclusive), sub-section (1) of section 216, and sections 234 and 235 of the Bankruptcy Code, 2016, came into force on April 1, 2017, as appointed by the Central Government." }, { "section_name": "", "short_title": "Verify Notification Details", "action_item": "Check and verify the details of the notification issued by the Ministry of Corporate Affairs, including the date of issue (March 30, 2017), and the file number (F. No. 30/7/2016-Insolvency Section)." }, { "section_name": "", "short_title": "Confirm Authority for Notification", "action_item": "Verify that the notification was issued in exercise of the powers conferred by sub-section (3) of section 1 of the Bankruptcy Code, 2016, and that it was issued by the Central Government." } ]

[ { "section_name": "प्रित/To, सभी जीवन बीमाकतार् / All Life Insurers िवषय: जीवन बीमा उ ादों संबंधी मा र प रपत्र Sub: Master Circular on Life Insurance Products", "short_title": "Review Master Circular", "action_item": "Review the Master Circular on Life Insurance Products to understand the provisions and guidelines applicable to life insurers." }, { "section_name": "प्रित/To, सभी जीवन बीमाकतार् / All Life Insurers िवषय: जीवन बीमा उ ादों संबंधी मा र प रपत्र Sub: Master Circular on Life Insurance Products", "short_title": "Verify Regulatory Compliance", "action_item": "Verify that the life insurer is in compliance with the provisions of Section 34 of the Insurance Act, 1938 and Section 14 of the IRDA Act, 1999 read with Regulation 7 of the IRDAI (Insurance Products) Regulations, 2024." }, { "section_name": "प्रित/To, सभी जीवन बीमाकतार् / All Life Insurers िवषय: जीवन बीमा उ ादों संबंधी मा र प रपत्र Sub: Master Circular on Life Insurance Products", "short_title": "Check Applicability", "action_item": "Check if the Master Circular is applicable to the life insurer, unless otherwise specified, and review the provisions to ensure compliance." }, { "section_name": "प्रित/To, सभी जीवन बीमाकतार् / All Life Insurers िवषय: जीवन बीमा उ ादों संबंधी मा र प रपत्र Sub: Master Circular on Life Insurance Products", "short_title": "Review Periodicity", "action_item": "Review the Master Circular every year to ensure that it is up-to-date and compliant with the latest regulations, unless review or repeal is warranted earlier." }, { "section_name": "प्रित/To, सभी जीवन बीमाकतार् / All Life Insurers िवषय: जीवन बीमा उ ादों संबंधी मा र प रपत्र Sub: Master Circular on Life Insurance Products", "short_title": "Verify Definitions", "action_item": "Verify that all words and expressions used in the Master Circular have the same meaning as defined in the Insurance Act, 1938, or the Insurance Regulatory and Development Authority Act, 1999, or Rules or Regulations made thereunder." } ]

[ { "section_name": "54. Disclosure Norms:", "short_title": "Review Disclosure in Sales Brochures", "action_item": "Review all sales brochures of linked insurance products to verify that they explicitly mention, using the same font size, 'In this policy, the investment risk in investment portfolio is borne by the policyholder' at the top of each document." }, { "section_name": "54. Disclosure Norms:", "short_title": "Verify Fund Details in Sales Brochures", "action_item": "Verify that all sales brochures of linked insurance products include the various funds offered, along with the details and objective of each fund." }, { "section_name": "54. Disclosure Norms:", "short_title": "Check Investment Strategy in Sales Brochures", "action_item": "Check that all sales brochures of linked insurance products provide the minimum and maximum percentage of investments in different types (like equities, debt, etc.) and the investment strategy to enable policyholders to make informed investment decisions." }, { "section_name": "54. Disclosure Norms:", "short_title": "Review Charge Definitions in Sales Brochures", "action_item": "Review all sales brochures of linked insurance products to verify that they include the definition of all applicable charges, the method of appropriation of these charges, and the quantum of charges levied under the terms and conditions of the policy." }, { "section_name": "54. Disclosure Norms:", "short_title": "Verify Charge Increase Limit in Sales Brochures", "action_item": "Verify that all sales brochures of linked insurance products mention the maximum limit up to which the insurer reserves the right to increase charges, subject to prior clearance of the Competent Authority." }, { "section_name": "54. Disclosure Norms:", "short_title": "Check Risk Profile in Sales Brochures", "action_item": "Check that all sales brochures of linked insurance products include the fundamental attributes and the risk profile (low, medium, or high) of different types of investments offered under various funds." }, { "section_name": "54. Disclosure Norms:", "short_title": "Review Liquidity Information in Promotion Material", "action_item": "Review all promotion materials of linked insurance products to verify that they display prominently in a bold font on the front page that 'the Linked Insurance Products do not offer any liquidity during the first five years of the contract' and that policyholders will not be able to surrender or withdraw monies invested completely or partially till the end of the fifth year." }, { "section_name": "54. Disclosure Norms:", "short_title": "Verify Annual Report on Insurer's Website", "action_item": "Verify that the insurer's website includes the annual report covering the fund performance during the preceding financial year in relation to the economic scenario, market developments, etc. for all linked insurance products." }, { "section_name": "54. Disclosure Norms:", "short_title": "Check Investment Strategies on Insurer's Website", "action_item": "Check that the insurer's website includes the investment strategies and risk control measures adopted for all linked insurance products." }, { "section_name": "54. Disclosure Norms:", "short_title": "Review Changes in Fundamentals on Insurer's Website", "action_item": "Review the insurer's website to verify that it includes information on changes in fundamentals, such as interest rates, tax rates, etc., affecting the investment portfolio for all linked insurance products." }, { "section_name": "54. Disclosure Norms:", "short_title": "Verify Fund Composition on Insurer's Website", "action_item": "Verify that the insurer's website includes the composition of the fund (debt, equity, and money market), analysis within various classes of investment, investment portfolio details, sectoral exposure of the underlying funds, and the ratings of investments made for all linked insurance products." }, { "section_name": "54. Disclosure Norms:", "short_title": "Check Performance Analysis on Insurer's Website", "action_item": "Check that the insurer's website includes analysis according to the duration of the investments held and the performance of the various funds over different periods like 1 year, 2 years, etc. for all linked insurance products." } ]

[ { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Review Application Forms", "action_item": "Review Application Forms as prescribed under Section VIII of this circular to verify compliance with the required documentation." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Verify Market Conduct Documents", "action_item": "Verify that all market conduct related documents are available, including sales literature, benefit illustration, online flow chart, policy document, Customer Information Sheet (CIS), key features document, proposal form, and any other market conduct related documents." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Check Certification I and II", "action_item": "Check that Certification I and II are completed as per Part B of Section-VIII and are properly documented." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Confirm Compliance with Para 32 and 53", "action_item": "Confirm that the organization is in compliance with para 32 and 53 of this circular and verify the confirmation documentation." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Review Duly Filled Check List", "action_item": "Review the duly filled in Check List as updated from time to time to verify that all required information is complete and accurate." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Verify Additional Required Documents", "action_item": "Verify that any other documents required to be filed as per other norms as applicable are available and properly documented." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Review Minutes of PMC Meeting", "action_item": "Review the minutes of the PMC meeting approving the product to verify that the product was properly approved." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Verify Justification of Pricing and/or Profit Testing", "action_item": "Verify that the justification of pricing and/or profit testing basis is properly documented and available for review." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Review Modified Product/Rider Documents", "action_item": "Review the documents for modification of existing product/rider, including the documents in para 75.1 & 75.2 in track changes mode, showing changes from the earlier version, and the Table of Changes showing all the changes from the existing version." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Verify Track Changes Mode Documents", "action_item": "Verify that the documents in para 75.1 & 75.2 are in track changes mode, showing changes from the earlier version, for modified products/riders." }, { "section_name": "Part-C: Document management for File & Use and Use & File procedure", "short_title": "Review Table of Changes", "action_item": "Review the Table of Changes to verify that it shows all the changes from the existing version for modified products/riders." } ]

[ { "section_name": "Section VI: Unique Identification Number (UIN):", "short_title": "Verify UIN Assignment", "action_item": "Review and verify that every life insurance product and rider, whether individual or group, has been assigned a unique identification number (UIN) before being introduced for sale in the market." }, { "section_name": "Section VI: Unique Identification Number (UIN):", "short_title": "Check UIN Quotation in Documents", "action_item": "Check and verify that the UIN is quoted in all relevant documents furnished to the policyholder, other users (public, distribution channels), and also in the returns filed/correspondence made with the IRDAI for each life insurance product and rider." }, { "section_name": "Section VI: Unique Identification Number (UIN):", "short_title": "Confirm UIN Usage in Market Introduction", "action_item": "Verify that a product/rider is introduced for sale in the market only after assigning the Unique Identification Number (UIN), as per the regulatory requirements." } ]

[ { "section_name": "Notes:", "short_title": "Verify Insurer Registration Number", "action_item": "Review the registration number of the insurer allotted by the IRDAI to identify the name of the insurer, which should be a 3-digit numeric value." }, { "section_name": "Notes:", "short_title": "Check Product/Rider Type Indicator", "action_item": "Verify that the product/rider type indicator is an alphabet that correctly represents the nature of the product/rider: L for Linked product, N for Non-linked product, A for Rider (linked), B for Rider (non-linked), G for Social Security Schemes or Government Schemes, or Y for Combi Product where Life insurer is Lead Insurer." }, { "section_name": "Notes:", "short_title": "Verify Product Serial Number", "action_item": "Check that the product serial number, which is a numeric value from 5 to 7, correctly indicates that the product is the nth product of the insurer and is a running serial number assigned by IRDAI, starting from 001." }, { "section_name": "Notes:", "short_title": "Verify Version Indicator", "action_item": "Review that the version indicator, which is an alphabet 'V', is correctly assigned to all products/riders." }, { "section_name": "Notes:", "short_title": "Verify Modification Serial Number", "action_item": "Check that the modification serial number, which is a numeric value from 9 to 10, correctly indicates the number of times the product is modified, starting from 01 for new products, and that the older version is no longer in the market from the date of the latest modification." }, { "section_name": "Notes:", "short_title": "Review IRDAI Website for Product Details", "action_item": "Verify that the IRDAI website (www.irdai.gov.in) publishes the details of products for public information, including the running serial number of products/riders, name of insurer registered with IRDAI, UIN assigned by IRDAI, brand name of the product/rider, date of clearance of product by the Competent Authority, and date from which the insurer stopped sale of the product/rider." }, { "section_name": "Notes:", "short_title": "Verify UIN Assignment", "action_item": "Check that the UIN assigned by the IRDAI is correctly reflected in the product details published on the IRDAI website." }, { "section_name": "Notes:", "short_title": "Verify Product Clearance Date", "action_item": "Review that the date of clearance of product by the Competent Authority is correctly reflected in the product details published on the IRDAI website, and that the insurer is allowed to offer the product/rider for sale in the market from this date." }, { "section_name": "Notes:", "short_title": "Verify Product Withdrawal Date", "action_item": "Verify that the date from which the insurer stopped sale of the product/rider is correctly reflected in the product details published on the IRDAI website." } ]

[ { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Review of Modifications to Withdrawn Life Insurance Products", "action_item": "Review the modifications permitted to withdrawn life insurance products to verify that they are in accordance with the conditions mentioned in the circular, including addition of existing riders, premium payment modes, reduction in interest rate, and addition of payment frequencies to income benefits." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Verification of Conditions for Modifications", "action_item": "Verify that the insurer has satisfied the conditions for allowing modifications to withdrawn life insurance products, including not altering/amending withdrawn File and Use applications, maintaining an addendum listing changes, informing policyholders, and documenting changes in policy documents." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Check for Policyholder Information and Consent", "action_item": "Check that policyholders are suitably informed about the options and have provided specific requests for modifications, and that the changes are not detrimental to their interests." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Review of Compliance with Extant Norms", "action_item": "Review that the insurer is complying with extant norms while offering modifications to withdrawn life insurance products, and that proper systems and processes are in place for policyholder information and decision-making." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Verification of Rider Term", "action_item": "Verify that the term of the rider does not exceed the outstanding policy term under the base policy." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Review of Product Management Committee (PMC) Approval", "action_item": "Review that the Product Management Committee (PMC) has reviewed and approved the changes to be introduced to withdrawn life insurance products, as required by regulation 6 of IRDAI (Insurance Products) Regulation, 2024." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Check for Annual Submission of Statement of Changes", "action_item": "Check that the insurer is submitting a statement of changes to withdrawn life insurance products on an annual basis, as per the Master Circular on Submission of Returns." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Verification of Document Management", "action_item": "Verify that the entire set of documents related to modifications to withdrawn life insurance products is maintained by the PMC as part of document management." }, { "section_name": "Section VII: Modifications permitted to withdrawn Life Insurance Products", "short_title": "Review of Application Forms for New or Modified Products", "action_item": "Review that the insurer is using the correct application form (Form No.-1- “Form IRDAI - Life-Non Linked”) for introducing new life insurance products or modifying existing products, as applicable." } ]

[ { "section_name": "", "short_title": "Review Form No.-2", "action_item": "Review Form No.-2 'Form IRDAI – Life – Linked' for Linked insurance products (both individual and group) to verify compliance with regulatory requirements." }, { "section_name": "", "short_title": "Review Form No.-3", "action_item": "Review Form No.-3 'Form-IRDAI-Life-Rider' for Riders (Linked and Non-Linked, Individual and Group) including Riders covering death and/or disability due to accident only to verify compliance with regulatory requirements." }, { "section_name": "", "short_title": "Verify Health Product/Rider Compliance", "action_item": "Verify that the Form for Health Product or Health Rider offered by Life Insurer is in accordance with the Master Circular on Health Insurance business vide circular No: IRDAI/HLT/CIR/PRO/84/5/2024 dated 29th May 2024." }, { "section_name": "", "short_title": "Check Withdrawal Notification", "action_item": "Check that the Life Insurer informs the Competent Authority within seven days from the date of withdrawal of an existing product, mentioning the name and UIN of the product along with the rationale for withdrawal." }, { "section_name": "", "short_title": "Verify Withdrawn Product F&U Application", "action_item": "Verify that once a product is withdrawn, the F&U application of the withdrawn product cannot be changed or modified." }, { "section_name": "", "short_title": "Review Separate Application for Each Product/Rider", "action_item": "Review that a separate application is made in respect of each product and rider, and that applications are made separately for riders attached to Linked and Non-Linked products, as well as for riders attached to Individual and Group products." }, { "section_name": "", "short_title": "Check Form Filing Instructions", "action_item": "Check that Life Insurers use the appropriate forms without altering or removing any sections or parts thereof, and that all sections in the Forms are complete in all respects along with submission of relevant details thereunder." }, { "section_name": "", "short_title": "Verify F&U Application Completeness", "action_item": "Verify that the F&U application Form along with all the necessary enclosures as per para 75 of this circular is furnished, and that the brand name of the product includes the name of the insurer as a prefix." }, { "section_name": "", "short_title": "Check Brand Name Consistency", "action_item": "Check that the brand name of the product which will be printed in Sales Literature and used for marketing the product is provided in the application, and that this name is not changed after launching in the market." }, { "section_name": "", "short_title": "Verify Application Form Information", "action_item": "Verify that the information provided in the application form is comprehensive and complete, and that cross-references to enclosures in the form are avoided as far as possible." }, { "section_name": "", "short_title": "Check Rider Approval", "action_item": "Check that the insurer does not attach any rider to the base products unless the riders are approved as per extant F&U or U&F procedure." }, { "section_name": "", "short_title": "Verify Document Modification Compliance", "action_item": "Verify that F&U and U&F application and other documents once approved are not altered without complying with the extant norms on modification of product." } ]

[ { "section_name": "", "short_title": "Review Profit Distribution", "action_item": "Review how profits/surplus will be distributed for participating products, including the type of bonuses (e.g., simple/compound reversionary bonuses, cash bonuses, terminal bonuses, etc.)" }, { "section_name": "", "short_title": "Verify Options Available", "action_item": "Verify the options available under the product, such as increase/decrease of sum assured, change in payment mode, etc." }, { "section_name": "", "short_title": "Check Minimum Group Size", "action_item": "Check the minimum size of the group for group products" }, { "section_name": "", "short_title": "Review Policy Loan Provisions", "action_item": "Review the policy loan provisions, including whether any loan is available on the policy, the scale of the loan amount available, and any applicable conditions" }, { "section_name": "", "short_title": "Verify Premium Payment Modes", "action_item": "Verify the modes of premiums permitted, including Single Pay, Yearly, Half-Yearly, Quarterly, Monthly, and Other (if applicable), and check for any loadings/discounts applicable for different modes" }, { "section_name": "", "short_title": "Check Loadings/Discounts", "action_item": "Check the loadings/discounts applicable for different modes of premium payment, including any discounts for high Sum Assured, high Premium, or other applicable discounts" }, { "section_name": "", "short_title": "Review Commissions/Remuneration", "action_item": "Review the scales of commissions/remuneration payable to agents/insurance intermediaries, ensuring compliance with Section 40 of the Insurance Act, 1938, and relevant regulations" }, { "section_name": "", "short_title": "Verify Other Features", "action_item": "Verify any other features relevant to the product, including approved riders with UIN, and check for any attachments to the basic product" }, { "section_name": "", "short_title": "Check Target Market", "action_item": "Check the target market for which the product is designed and review any market research conducted for this purpose" }, { "section_name": "", "short_title": "Verify Distribution Channels", "action_item": "Verify the distribution channels to be used for distributing the product, including expected proportions of business to be procured by each channel" }, { "section_name": "", "short_title": "Review Underwriting Procedures", "action_item": "Review the treatment of different classes for underwriting purposes, including procedures for assessing various risk classes, such as males, females, transgender, smokers/non-smokers, and sub-standard lives" }, { "section_name": "", "short_title": "Check General Policy Provisions", "action_item": "Check the general policy provisions, including suicide claim provisions, exclusions, grace period for non-forfeiture provisions, nomination and assignment requirements, and approach to revivals or reinstatements" }, { "section_name": "", "short_title": "Verify Exclusions", "action_item": "Verify any exclusions, such as occupational hazard or travel, and check for any applicable conditions" }, { "section_name": "", "short_title": "Review Nomination and Assignment", "action_item": "Review the nomination and assignment requirements, referring to Sections 39 and 38 of the Insurance Act, 1938, respectively" } ]

[ { "section_name": "", "short_title": "Review Reinsurance Arrangements", "action_item": "Review the reinsurance arrangements to verify that they include the name of the reinsurer, type of reinsurance, retention limit, premium rates, commissions, and any recapture provisions." }, { "section_name": "", "short_title": "Verify Pricing Methodology", "action_item": "Verify that the pricing methodology for each product variant is properly described and includes target profit margin." }, { "section_name": "", "short_title": "Check Pricing Assumptions", "action_item": "Check the pricing assumptions to ensure they include details of rate of mortality, rates of morbidity, rates of policy terminations/withdrawal, rate of interest, bonus rates, guaranteed cash values, commission scales, and expenses, along with justification for each assumption." }, { "section_name": "", "short_title": "Verify Mortality Rate Tables", "action_item": "Verify that the tables used for rate of mortality are as per the extant regulations." }, { "section_name": "", "short_title": "Verify Morbidity Rate Tables", "action_item": "Verify that the tables used for rates of morbidity are as per the extant regulations." }, { "section_name": "", "short_title": "Check Policy Termination/Withdrawal Rates", "action_item": "Check that the rates used for policy terminations/withdrawal are in accordance with the insurer's experience, or if not available, based on industry/reinsurer's experience." }, { "section_name": "", "short_title": "Verify Rate of Interest", "action_item": "Verify that the rate or rates of interest used are consistent with the investment policy of the insurer." }, { "section_name": "", "short_title": "Check Bonus Loading Assumptions", "action_item": "Check the bonus loading assumptions in case of par policies to ensure they are properly factored into pricing." }, { "section_name": "", "short_title": "Verify Guaranteed Cash Values", "action_item": "Verify that the guaranteed cash values, including guaranteed surrender values, are properly described and factored into pricing." }, { "section_name": "", "short_title": "Check Commission Scales", "action_item": "Check the rates of commission/remuneration/rewards factored into pricing, along with any other related assumptions." }, { "section_name": "", "short_title": "Verify Expense Assumptions", "action_item": "Verify that the expense assumptions are company-specific, compliant with extant regulations, and split into first-year expenses and renewal expenses, including overhead expenses, and claim expenses." }, { "section_name": "", "short_title": "Check First-Year Expenses", "action_item": "Check that the first-year expenses are properly categorized by sum assured related, premium related, and per policy related." }, { "section_name": "", "short_title": "Check Renewal Expenses", "action_item": "Check that the renewal expenses, including overhead expenses, are properly categorized by sum assured related, premium related, and per policy related." }, { "section_name": "", "short_title": "Verify Claim Expenses", "action_item": "Verify that the claim expenses include a provision for future inflationary increases." }, { "section_name": "", "short_title": "Check Allowance for Transfers to Shareholder", "action_item": "Check if an allowance for transfers to shareholder is made, and if so, verify that it is in accordance with section 49 of the Insurance Act, 1938, and IRDAI (Actuarial, Finance and Investment Function of Insurers) Regulations, 2024." }, { "section_name": "", "short_title": "Verify Taxation Assumptions", "action_item": "Verify that the taxation assumptions are based on the relevant sections of the Income Tax Act, 1961, as amended from time to time." }, { "section_name": "", "short_title": "Check Volume of New Business", "action_item": "Check the expected premium income for the next 5 years, categorized by distribution channels." } ]

[ { "section_name": "", "short_title": "Review Average Sum Assured for Pricing", "action_item": "Review the average sum assured used for pricing to verify its accuracy and relevance." }, { "section_name": "", "short_title": "Verify Risk Discount Rate", "action_item": "Verify the Risk Discount Rate used for pricing, along with the rationale provided, to ensure it is reasonable and justifiable." }, { "section_name": "", "short_title": "Check Other Pricing Parameters", "action_item": "Check if any other parameters assumed relevant for pricing of the product are properly documented and justified." }, { "section_name": "", "short_title": "Review Financial Projections Results", "action_item": "Review the results of financial projections to ensure they are accurate and complete." }, { "section_name": "", "short_title": "Verify Profit Margins", "action_item": "Verify that the profit margins are shown for various model points for base, optimistic, and pessimistic scenarios in a tabular format." }, { "section_name": "", "short_title": "Check Financial Projections Summary", "action_item": "Check that the financial projections summary contains profit margin information for at least 100 model points, including the model points resulting in the lowest and highest profit margins." }, { "section_name": "", "short_title": "Review Assumptions for Reserve Calculations", "action_item": "Review the assumptions used for calculating reserves under the product and verify that they are reasonable and properly documented." }, { "section_name": "", "short_title": "Verify Bases for Profit Test Calculations", "action_item": "Verify that the bases for profit test calculations are properly documented and justified." }, { "section_name": "", "short_title": "Review New Business Strain", "action_item": "Review the new business strain for the next 5 years to ensure it is accurately projected and properly documented." }, { "section_name": "", "short_title": "Check Sample Cash Flow Statements", "action_item": "Check that sample cash flow statements are provided under the base scenario for at least 10 model points, including the model points resulting in the lowest and highest profit margins." }, { "section_name": "", "short_title": "Review Sensitivity Analysis", "action_item": "Review the sensitivity analysis to ensure it is properly conducted and the results are accurately reported in a tabular format, along with relevant comments from the Appointed Actuary." }, { "section_name": "", "short_title": "Verify Proposal Form Compliance", "action_item": "Verify that the proposal form complies with extant norms, such as Section 41 and Section 45 of the Insurance Act, 1938." }, { "section_name": "", "short_title": "Review Sales Literature", "action_item": "Review the sales literature to ensure it accurately enumerates all the salient features of the product, along with exclusions applicable for the basic benefits and riders attached." }, { "section_name": "", "short_title": "Check Policy Bond", "action_item": "Check that a specimen copy of the policy bond to be issued to the purchaser of the insurance product is provided and accurately reflects the terms and conditions of the insurance contract." } ]

[ { "section_name": "", "short_title": "Review Product Description", "action_item": "Review the product description to verify that it includes the nature and classification of the product, contingencies covered, and benefits payable on happening of the contingencies covered." }, { "section_name": "", "short_title": "Verify Investment Policy", "action_item": "Verify that the investment policy is described for each segregated fund, as per section 8.1." }, { "section_name": "", "short_title": "Check Benefit Payable Contingencies", "action_item": "Check that the product features describe the various contingencies under which benefits would be payable, including death, survival, discontinuance, surrender, lapse, or any other contingency, as per section 8.2." }, { "section_name": "", "short_title": "Review Benefit Payment Conditions", "action_item": "Review the conditions attached to each benefit payable under the product, including how and when the benefit amounts are payable under each variant (if any)." }, { "section_name": "", "short_title": "Verify Specimen Table", "action_item": "Verify that the specimen table (or equivalent) is provided to illustrate benefits during the term of the policy, including the benefits payable under each contingency." } ]

[ { "section_name": "", "short_title": "Review Non-forfeiture Benefits", "action_item": "Review the policy document to verify that it specifies the non-forfeiture benefits, including surrender value and paid-up value, and that the formula used is clearly stated along with the assumptions made." }, { "section_name": "", "short_title": "Verify Options Available Under the Product", "action_item": "Verify that the policy document specifies the various options available under the product, such as increasing or decreasing the sum assured, changing the premium payment mode, and that the charges associated with these options are clearly stated." }, { "section_name": "", "short_title": "Check Charges and Frequency of Charges", "action_item": "Check the policy document to verify that all charges, including switching charges, are specified and that the frequency of these charges is clearly stated." }, { "section_name": "", "short_title": "Review Minimum Guarantees", "action_item": "Review the policy document to verify that it specifies the minimum guarantees available, including benefits, cash surrender values, paid-up values, and charges." }, { "section_name": "", "short_title": "Verify Minimum Group Size", "action_item": "Verify that the policy document specifies the minimum size of the group, if applicable, for group products." }, { "section_name": "", "short_title": "Check Unit Encashment Conditions", "action_item": "Check the policy document to verify that the unit encashment conditions are clearly stated." }, { "section_name": "", "short_title": "Review Modes of Premium Payment", "action_item": "Review the policy document to verify that it specifies the modes of premium payment permitted, such as single pay, yearly, half-yearly, quarterly, monthly, or other, and that the charges applied for different modes of premium payment are clearly stated." }, { "section_name": "", "short_title": "Verify Loadings/Discounts for Premium Payment Modes", "action_item": "Verify that the policy document specifies the loadings or discounts applicable for different modes of premium payment and that the selection of each mode of premium payment is clearly stated." } ]

[ { "section_name": "", "short_title": "Review Discount for High Sum Assured", "action_item": "Review the discount for high sum assured / high premium / any other, as applicable, to verify that it is in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Verify Scales of Commissions", "action_item": "Verify the scales of commissions/remuneration/rewards payable to the agent/insurance intermediaries, as specified in section 8.10, to ensure compliance with Section 40 of the Insurance Act, 1938 and relevant provisions of extant regulations." }, { "section_name": "", "short_title": "Review Other Features", "action_item": "Review any other features that may be relevant for the product, as specified in section 8.11, to verify that they are in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Verify Target Market", "action_item": "Verify the target market for which the product is designed, as specified in section 9, to ensure that it is in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Review Distribution Channels", "action_item": "Review the various distribution channels to be used for distributing the product, as specified in section 10, to verify that they are in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Verify Treatment of Different Classes", "action_item": "Verify how the different segments of the population will be dealt with for the purpose of underwriting, as specified in section 11, to ensure that it is in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Review General Policy Provisions", "action_item": "Review the general policy provisions, as specified in section 12, to verify that they are in accordance with the organization's policies and procedures, including suicide claim provisions, exclusions, grace period for non-forfeiture provisions, nomination and assignments requirements, and general approach to be used for revivals or reinstatements, policy changes/alterations, etc." }, { "section_name": "", "short_title": "Verify Suicide Claim Provisions", "action_item": "Verify the amount of claim payment, if any, to be made on suicide, as specified in section 12.a, to ensure that it is in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Review Exclusions", "action_item": "Review any exclusions, as specified in section 12.b, to verify that they are in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Verify Grace Period", "action_item": "Verify the grace period for non-forfeiture provisions, as specified in section 12.c, to ensure that it is in accordance with the organization's policies and procedures." }, { "section_name": "", "short_title": "Review Nomination and Assignments Requirements", "action_item": "Review the nomination and assignments requirements, as specified in section 12.d, to verify that they are in accordance with Section 39 and 38 of the Insurance Act, 1938, respectively." }, { "section_name": "", "short_title": "Verify Revivals or Reinstatements", "action_item": "Verify the general approach to be used for revivals or reinstatements, policy changes/alterations, etc., as specified in section 12.e, to ensure that it is in accordance with the organization's policies and procedures." } ]

[ { "section_name": "", "short_title": "Review Reinsurance Arrangements", "action_item": "Review the reinsurance arrangements to verify that they are properly described, including the name of the reinsurer and the terms of reinsurance such as type of reinsurance, retention limit, premium rates, commissions, and any recapture provisions." }, { "section_name": "", "short_title": "Verify Pricing Methodology", "action_item": "Verify that the pricing methodology is properly described for each product variant, including the target profit margin." }, { "section_name": "", "short_title": "Check Pricing Assumptions", "action_item": "Check the pricing assumptions to ensure they are properly justified, including rate of mortality, rates of morbidity, rates of policy terminations/withdrawal, rate of interest assumed on non-unit reserves, guaranteed cash values, commission scales, and expenses." }, { "section_name": "", "short_title": "Verify Mortality Tables", "action_item": "Verify that the mortality tables used are as per the extant regulations." }, { "section_name": "", "short_title": "Verify Morbidity Tables", "action_item": "Verify that the morbidity tables used are as per the extant regulations." }, { "section_name": "", "short_title": "Review Policy Termination Rates", "action_item": "Review the rates of policy terminations/withdrawal to ensure they are in accordance with the insurer's experience or industry/reinsurer's experience if the insurer's experience is not available." }, { "section_name": "", "short_title": "Verify Interest Rate Assumptions", "action_item": "Verify that the rate of interest assumed on non-unit reserves is consistent with the investment policy of the insurer." }, { "section_name": "", "short_title": "Check Guaranteed Cash Values", "action_item": "Check that the guaranteed cash values, including guaranteed surrender values, are properly described." }, { "section_name": "", "short_title": "Verify Commission Scales", "action_item": "Verify that the commission scales, including rates of commission/remuneration/reward, are properly factored into pricing along with any other related assumptions." }, { "section_name": "", "short_title": "Review Expense Assumptions", "action_item": "Review the expense assumptions to ensure they are company-specific, compliant with extant regulations, and split into first-year expenses, renewal expenses, claim expenses, and others." }, { "section_name": "", "short_title": "Verify First-Year Expenses", "action_item": "Verify that the first-year expenses are properly categorized by sum assured related, premium related, and per policy related." }, { "section_name": "", "short_title": "Verify Renewal Expenses", "action_item": "Verify that the renewal expenses, including overhead expenses, are properly categorized by sum assured related, premium related, and per policy related." }, { "section_name": "", "short_title": "Check Claim Expenses", "action_item": "Check that the claim expenses are properly accounted for." }, { "section_name": "", "short_title": "Verify Other Expenses", "action_item": "Verify that other expenses, such as investment/fund-related expenses, are properly accounted for, including any provision for future inflationary increases." }, { "section_name": "", "short_title": "Review Mortality/Morbidity Charge", "action_item": "Review the mortality/morbidity charge to ensure it is properly described." }, { "section_name": "", "short_title": "Verify Allocation Rate", "action_item": "Verify that the allocation rate is properly described." }, { "section_name": "", "short_title": "Check Fund Management Charge", "action_item": "Check that the fund management charge is properly described." }, { "section_name": "", "short_title": "Verify Surrender/Discontinuance Charges", "action_item": "Verify that the surrender/discontinuance charges are properly described." }, { "section_name": "", "short_title": "Review Allowance for Transfers to Shareholder", "action_item": "Review the allowance for transfers to shareholder to ensure it is in accordance with section 49 of the Insurance Act, 1938, and IRDAI (Actuarial, Finance and Investment Function of Insurers) Regulations, 2024." }, { "section_name": "", "short_title": "Verify Taxation Assumptions", "action_item": "Verify that the taxation assumptions are properly described and refer to the relevant sections of the Income Tax Act, 1961, as amended from time to time." }, { "section_name": "", "short_title": "Check Profit Margins", "action_item": "Check that the profit margins are properly shown for various model points for base, optimistic, and pessimistic scenarios in a tabular format, along with the definition of profit margin." }, { "section_name": "", "short_title": "Verify Volume of New Business", "action_item": "Verify that the expected premium income for the next 5 years is properly described by distribution channels." }, { "section_name": "", "short_title": "Check Average Sum Assured", "action_item": "Check that the average sum assured is properly described for pricing of the product." }, { "section_name": "", "short_title": "Review Assumption on Valuation of Reserves", "action_item": "Review the assumption on valuation of unit and non-unit reserves to ensure it is properly described." }, { "section_name": "", "short_title": "Verify Risk Discount Rate", "action_item": "Verify that the risk discount rate is properly described, along with the rationale." }, { "section_name": "", "short_title": "Check Other Pricing Parameters", "action_item": "Check that any other parameters assumed relevant for pricing of the product, such as guaranteed benefits/charges, are properly described." } ]

[ { "section_name": "", "short_title": "Review Rider Filing Status", "action_item": "Review whether the rider is being filed for the first time and verify the response to question 5.1 (i) as 'Yes' or 'No'." }, { "section_name": "", "short_title": "Verify New Rider Details", "action_item": "If the rider is being filed for the first time, check that the name of the product(s) to which it is to be attached is provided, along with the unique identification number (UIN) of the base products." }, { "section_name": "", "short_title": "Review Existing Rider Details", "action_item": "If the rider is not being filed for the first time, verify the date of first filing of the rider as per 5.1 (ii) (a)." }, { "section_name": "", "short_title": "Check Product Attachment History", "action_item": "Review the name and UIN of the products to which the rider was attached or removed from the date of clearance, as per 5.1 (ii) (b), and verify that the information is provided in the specified tabular form." }, { "section_name": "", "short_title": "Verify Rider Modification Status", "action_item": "Check whether the rider features/assumptions have been modified from the date of clearance, as per 5.1 (ii) (c), and verify the response as 'Yes' or 'No'." }, { "section_name": "", "short_title": "Review Rider Modification Details", "action_item": "If the rider features/assumptions have been modified, verify that the information on all modifications carried out till date is provided in the specified tabular format, as per 5.1 (ii) (c) (i)." } ]

[ { "section_name": "", "short_title": "Review Non-forfeiture Benefits", "action_item": "Review the non-forfeiture benefits (cash surrender value, paid-up value, automatic premium loans etc.) to verify that they are in compliance with section 113 of the Insurance Act, 1938, IRDAI (Insurance Products) Regulations, 2024 and other applicable norms." }, { "section_name": "", "short_title": "Verify Surrender Values", "action_item": "Verify that surrender values, if any, are specified and that the insurer has filed the non-guaranteed (special) surrender values, if any, with the Competent Authority." }, { "section_name": "", "short_title": "Check Options Available Under the Rider", "action_item": "Check the options available under the rider, such as increase of sum assured, change in payment mode etc., and verify that the charges, if any, towards the cost of the option are specified." }, { "section_name": "", "short_title": "Review Modes of Premium Payment", "action_item": "Review the modes of premium payment permitted and verify that the charges applied for different modes of premium payment and quantum of sum assured, if any, are specified." }, { "section_name": "", "short_title": "Verify Loadings/Discount Applicable", "action_item": "Verify the loadings/discount applicable for different modes of premium payment and that the modes and loadings/discount applicable for selection of each mode of premium payment are specified." }, { "section_name": "", "short_title": "Check Discount for High Sum Assured", "action_item": "Check if a discount is applicable for high Sum Assured / high Premium/ any other, and verify that the discount is specified." }, { "section_name": "", "short_title": "Verify Other Discounts", "action_item": "Verify if any other discounts, such as discount for Online Sales, are applicable and that they are specified." }, { "section_name": "", "short_title": "Review Scales of Commissions", "action_item": "Review the scales of commissions/remuneration/rewards payable to the agents/insurance intermediaries and verify that they are in compliance with section 40 of the Insurance Act, 1938 and relevant provisions of extant regulations." }, { "section_name": "", "short_title": "Check Treatment of Different Classes", "action_item": "Check the treatment of different classes for the purpose of underwriting, such as males, females, and transgender, smokers/non-smokers, limitations on entry ages, sub-standard lives, and any other classifications that may be relevant to the rider." }, { "section_name": "", "short_title": "Verify General Policy Provisions", "action_item": "Verify the general policy provisions, including suicide claim provisions, exclusions, if any, grace period for non-forfeiture provisions, nomination and assignment requirements, and general approach to be used for revivals or reinstatements." }, { "section_name": "", "short_title": "Review Reinsurance Arrangements", "action_item": "Review the reinsurance arrangements, including the name of the reinsurer, terms of reinsurance, type of reinsurance, retention limit, premium rates, commissions, etc., and verify that any recapture provisions are described." }, { "section_name": "", "short_title": "Check Financial Projections", "action_item": "Check the financial projections, including pricing methodology and target profit margin, and verify that the pricing assumptions, such as rate of mortality, rates of morbidity, rates of policy terminations/withdrawal, rate of interest, commission scales, average sum assured, and any other parameter assumed relevant for pricing of the product, are specified and justified." }, { "section_name": "", "short_title": "Verify Allowance for Transfers to Shareholder", "action_item": "Verify that the allowance for transfers to shareholder, if any, is in compliance with section 49 of the Insurance Act, 1938 read with IRDAI (Actuarial, Finance and Investment Function of Insurers) Regulations, 2024." }, { "section_name": "", "short_title": "Check Taxation", "action_item": "Check the taxation provisions and verify that they are in compliance with the relevant sections of the Income Tax Act, 1961, as amended from time to time." } ]

[ { "section_name": "", "short_title": "Review Volume of New Business Projections", "action_item": "Review the volume of new business projections for the next 5 years, including expected premium income for the base product, base product with rider, and rider separately, and verify the proportion of rider premium income as a percentage of main product premium income." }, { "section_name": "", "short_title": "Verify Risk Discount Rate", "action_item": "Verify the risk discount rate used and review the rationale provided for its selection." }, { "section_name": "", "short_title": "Review Assumptions for Financial Projections", "action_item": "Review any other parameters assumed relevant for the rider and verify their impact on financial projections." }, { "section_name": "", "short_title": "Analyze Profit Margins", "action_item": "Analyze the profit margins for various model points under base, optimistic, and pessimistic scenarios, and verify the definition of profit margin as the present value of net profits to the present value of premiums." }, { "section_name": "", "short_title": "Verify Financial Projections Summary", "action_item": "Verify the financial projections summary containing profit margins for 100 model points, including the model points resulting in the lowest and highest profit margins, for the base product, rider, and base product with rider combined." }, { "section_name": "", "short_title": "Review Assumptions for Reserve Calculations", "action_item": "Review the assumptions for calculating reserves under the rider and verify the bases for profit test calculations." }, { "section_name": "", "short_title": "Verify New Business Strain Projections", "action_item": "Verify the new business strain projections for each of the next 5 years for the rider alone and the base product with rider." }, { "section_name": "", "short_title": "Review Sample Cash Flow Statements", "action_item": "Review the sample cash flow statements under the base scenario for 10 model points and verify the mention of model points." }, { "section_name": "", "short_title": "Analyze Sensitivity Analysis", "action_item": "Analyze the sensitivity analysis results, including assumptions and calculations, for each scenario, and verify the basis for calculations, such as the risk discount rate." }, { "section_name": "", "short_title": "Verify Proposal Form and Sales Literature", "action_item": "Verify the proposal form and sales literature, including the specimen copy of the proposal form and sales literature, and review the relevant provisions and questions for the rider." }, { "section_name": "", "short_title": "Review Policy Endorsement for Rider", "action_item": "Review the policy endorsement for the rider and verify its attachment to the base product." }, { "section_name": "", "short_title": "Verify Rider Premium/Charge Tables", "action_item": "Verify the rider premium/charge tables and review the premium rates/charges and premium calculator, if any, on the insurer's website." }, { "section_name": "", "short_title": "Review Certification", "action_item": "Review the certification from the Appointed Actuary/Panel Actuary, Chairman of PMC, and countersigned by the principal officer, and verify that the text of certification has not been altered." } ]

[ { "section_name": "Certification II: Certification by PMC and counter signed by CEO (For U&F and F&U)", "short_title": "Review Master Circular Compliance", "action_item": "Review and verify that all provisions of the Master Circular on Life Insurance Product Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 dated 12.06.2024 have been complied with, as applicable for new or modification of life insurance products." }, { "section_name": "Certification II: Certification by PMC and counter signed by CEO (For U&F and F&U)", "short_title": "Verify Applicable Norms Compliance", "action_item": "Check and confirm that all other applicable norms have been complied with, as relevant to the certification process for life insurance products." }, { "section_name": "Certification II: Certification by PMC and counter signed by CEO (For U&F and F&U)", "short_title": "Confirm Certification by PMC and CEO", "action_item": "Verify that the certification has been properly signed by the PMC (Product Management Committee) and counter-signed by the CEO, as required for U&F (Unit-Linked and Fixed) and F&U (Fixed and Unit-Linked) products." } ]

[ { "section_name": "संदभर्: आईआरडीएआई/एसीटीएल/एमएसटीसीआईआर/िविवध/89/6/2024 िदनांक: 12 जून, 2024 Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 Date: 12th June, 2024", "short_title": "Review Product/Rider Compliance", "action_item": "Review the product/rider <<brand name>> filed on <<filing date>> to verify that it complies with all relevant rules, terms, conditions, and policies." }, { "section_name": "संदभर्: आईआरडीएआई/एसीटीएल/एमएसटीसीआईआर/िविवध/89/6/2024 िदनांक: 12 जून, 2024 Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 Date: 12th June, 2024", "short_title": "Verify Ongoing Compliance", "action_item": "Verify that the product/rider <<brand name>> continues to be complied with in respect of all relevant rules, terms, conditions, and policies." }, { "section_name": "संदभर्: आईआरडीएआई/एसीटीएल/एमएसटीसीआईआर/िविवध/89/6/2024 िदनांक: 12 जून, 2024 Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 Date: 12th June, 2024", "short_title": "Check for Non-Compliance", "action_item": "Check for any non-compliance observed in respect of the product/rider <<brand name>> and verify that appropriate action is taken under the applicable provisions of the Insurance Act, 1938 or any other applicable legal / regulatory norms." }, { "section_name": "संदभर्: आईआरडीएआई/एसीटीएल/एमएसटीसीआईआर/िविवध/89/6/2024 िदनांक: 12 जून, 2024 Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 Date: 12th June, 2024", "short_title": "Verify Accuracy of Information", "action_item": "Verify that the information provided regarding the product/rider <<brand name>> is correct and not misleading." }, { "section_name": "संदभर्: आईआरडीएआई/एसीटीएल/एमएसटीसीआईआर/िविवध/89/6/2024 िदनांक: 12 जून, 2024 Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 Date: 12th June, 2024", "short_title": "Review Signatures and Dates", "action_item": "Review the signatures and dates of the Appointed Actuary, Chairperson of PMC, and CEO to ensure that they are properly signed and dated." }, { "section_name": "Certification-III: Table of Changes and certification applicable on modification of Product or Rider", "short_title": "Review Certification Document", "action_item": "Review the certification document for modification of product or rider to verify that it includes the name of the insurer, brand name of the product/rider, UIN of the existing version, and UIN of the modified version." }, { "section_name": "Certification-III: Table of Changes and certification applicable on modification of Product or Rider", "short_title": "Verify Changes Made", "action_item": "Verify that the certification document accurately reflects the changes made to the existing product or rider and that no other changes apart from those listed have been made." }, { "section_name": "Certification-III: Table of Changes and certification applicable on modification of Product or Rider", "short_title": "Check Appointed Actuary Signature", "action_item": "Check that the certification document includes the signature and name of the Appointed Actuary, along with the date." }, { "section_name": "Certification-III: Table of Changes and certification applicable on modification of Product or Rider", "short_title": "Verify Chairperson of PMC Signature", "action_item": "Verify that the certification document includes the signature, name, and designation of the Chairperson of the Product Management Committee (PMC), along with the date." }, { "section_name": "Certification-III: Table of Changes and certification applicable on modification of Product or Rider", "short_title": "Check CEO Signature", "action_item": "Check that the certification document includes the signature and name of the CEO, along with the date." }, { "section_name": "Certification-III: Table of Changes and certification applicable on modification of Product or Rider", "short_title": "Review Place and Date", "action_item": "Review the certification document to verify that it includes the place and date of signing." } ]

[ { "section_name": "Certification-IV", "short_title": "Review Compliance with Regulatory Framework", "action_item": "Review the proposed product to verify compliance with the provisions of the Insurance Act, 1938, the IRDA Act, 1999, other applicable Acts and amendments, extant Regulatory framework, and circulars issued by the Authority." }, { "section_name": "Certification-IV", "short_title": "Verify Document Maintenance", "action_item": "Verify that the insurer maintains the entire set of documents required under U&F Procedure and submits the documents to the IRDAI as and when required, within two days." }, { "section_name": "Certification-IV", "short_title": "Check Modification Process", "action_item": "Check that the insurer does not modify the product without completing the due process mandated for modifications." }, { "section_name": "Certification-IV", "short_title": "Review Systems and Infrastructure", "action_item": "Review that the insurer has put in place appropriate systems, procedures, manuals, and all essential infrastructure required for launching the product and maintenance of insurance policies." }, { "section_name": "Certification-IV", "short_title": "Verify Document Upload", "action_item": "Verify that the insurer uploads all the required documents of the product on the website." }, { "section_name": "Certification-IV", "short_title": "Check Signatures and Dates", "action_item": "Check that the certification includes the signature and name of the Appointed Actuary, Chairperson of PMC, and CEO, along with the respective dates." } ]

[ { "section_name": "", "short_title": "Review Certification-V Statement", "action_item": "Review the Certification-V statement to verify that it accurately represents the existing insurance products and riders that comply with the IRDAI (Insurance Products) Regulations, 2024." }, { "section_name": "", "short_title": "Verify Compliance with IRDAI Regulations", "action_item": "Verify that the existing insurance products and riders listed in the Certification-V statement comply with the provisions of the IRDAI (Insurance Products) Regulations, 2024." }, { "section_name": "", "short_title": "Check Master Circular Compliance", "action_item": "Check that the existing insurance products and riders listed in the Certification-V statement comply with the provisions of the Master Circular on Life Insurance Product Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 dated 12.06.2024." }, { "section_name": "", "short_title": "Verify Appointed Actuary Signature and Date", "action_item": "Verify that the Certification-V statement contains the signature and name of the Appointed Actuary, along with the date of signature." }, { "section_name": "", "short_title": "Verify Chairperson of PMC Signature and Date", "action_item": "Verify that the Certification-V statement contains the signature, name, and designation of the Chairperson of the PMC, along with the date of signature." }, { "section_name": "", "short_title": "Verify CEO Signature and Name", "action_item": "Verify that the Certification-V statement contains the signature and name of the CEO." } ]

[ { "section_name": "", "short_title": "Review Certification-VII", "action_item": "Review the certification statement to verify that the insurance products and riders modified due to non-compliance with the IRDAI (Insurance Products) Regulations, 2024, and other applicable norms, are accurately listed and properly certified by the Appointed Actuary, CEO, and Chairperson of the PMC." }, { "section_name": "", "short_title": "Verify Signatures and Dates", "action_item": "Verify that the certification statements (Certification-VII and Certification-VIII) are signed by the Appointed Actuary, CEO, and Chairperson of the PMC, with the corresponding dates, to ensure authenticity and compliance." }, { "section_name": "", "short_title": "Check Compliance with IRDAI Regulations", "action_item": "Check that the modified insurance products and riders comply with the IRDAI (Insurance Products) Regulations, 2024, and the provisions of the Master Circular on Life Insurance Product (Ref: IRDAI/ACTL/MSTCIR/MISC/89/6/2024 dated 12.06.2024)." }, { "section_name": "", "short_title": "Review Withdrawn Group Products", "action_item": "Review the list of Group products/riders withdrawn from the market for new business due to non-compliance with IRDAI (Insurance Products) Regulations, 2024, and verify that they are being continued only for existing members as of the effective date of the circular." }, { "section_name": "", "short_title": "Verify Continued Products for Existing Members", "action_item": "Verify that the Group products/riders withdrawn from the market are indeed being continued for members existing on the effective date of the circular, and not for new business or other purposes." } ]

[ { "section_name": "", "short_title": "Verify Appointed Actuary Signature", "action_item": "Review and verify that the signature and name of the Appointed Actuary are present and dated." }, { "section_name": "", "short_title": "Verify Chairperson of PMC Signature", "action_item": "Review and verify that the signature, name, and designation of the Chairperson of the Project Management Committee (PMC) are present and dated." } ]

[ { "section_name": "Section IX: Customer Information Sheet CUSTOMER INFORMATION SHEET / KNOW YOUR POLICY", "short_title": "Review Customer Information Sheet", "action_item": "Review the Customer Information Sheet to verify that it provides key information about the policy, and check that it advises the customer to go through their policy document." }, { "section_name": "Section IX: Customer Information Sheet CUSTOMER INFORMATION SHEET / KNOW YOUR POLICY", "short_title": "Verify Policy Document Availability", "action_item": "Verify that the policy document is available for customers to review, as advised in the Customer Information Sheet." }, { "section_name": "Section IX: Customer Information Sheet CUSTOMER INFORMATION SHEET / KNOW YOUR POLICY", "short_title": "Check Policy Document Content", "action_item": "Check the policy document to confirm that it contains all the necessary information relevant to the customer's policy." } ]

[ { "section_name": "Note:", "short_title": "Verify Web-link for Product Documents", "action_item": "Review the insurer's website to verify that a web-link is provided where product-related documents, including the Customer Information sheet, are available." }, { "section_name": "Note:", "short_title": "Confirm Prevalence of Policy Document Terms", "action_item": "Verify that in case of any conflict, the terms and conditions mentioned in the policy document prevail over other documents or communications." }, { "section_name": "Note:", "short_title": "Check Confirmation of Customer Information Sheet Receipt", "action_item": "Check that the insurer has taken confirmation from the policyholder regarding the receipt of the Customer Information Sheet." } ]

[ { "section_name": "", "short_title": "Review Policy Surrender Charges Refund", "action_item": "Review and verify that the policy surrender charges are refunded to the fund when a policy is surrendered, as per the specified guidelines." } ]

[]

[ { "section_name": "", "short_title": "Review of Revision Procedure", "action_item": "Review the procedure for revising existing products to ensure that any revisions are filed as new products under the relevant regulations, such as UA or FA, as applicable." }, { "section_name": "", "short_title": "Verification of Revision Timing", "action_item": "Verify that revisions to existing products are made after a reasonable period following the commencement of the current version, based on credible experience or robust market indicators, and in accordance with BAPMPP." }, { "section_name": "", "short_title": "Withdrawal of Existing Products", "action_item": "Check that existing products or riders are withdrawn from the market before the introduction of their revised versions, for new business." }, { "section_name": "", "short_title": "UIN Revision Procedure", "action_item": "Review the procedure for revising the Unique Identification Number (UIN) of a product, to ensure that it follows the existing procedure, where the last three characters/digits of the UIN denote the 'version' of the product." }, { "section_name": "", "short_title": "Compliance with Insurance Act", "action_item": "Verify that no life insurance product is issued to any person who is not authorized under the provisions of the Insurance Act, 1938, for the purpose of solicitation and procurement of insurance business." } ]

[ { "section_name": "", "short_title": "Review Rider Types", "action_item": "Review and verify that all riders, including but not limited to, saavidha rider, dugharṭanāvaś mṛtyu lābh rider, dugharṭanāvaś kul/āṃśik ṇiyantā rider, prīmīyam se chūṭ sa yu rider, gambhīr ātā rider, and antima ātā rider, are properly documented and implemented." }, { "section_name": "", "short_title": "Verify Compliance with Regulations", "action_item": "Verify that all mixed (composite) products, where the life insurer is a leading insurer, comply with the provisions of this document." }, { "section_name": "", "short_title": "Check Amendments to Existing Products", "action_item": "Check and verify that amendments to existing products are categorized and implemented in accordance with the regulations, including those with and without UIN modifications." }, { "section_name": "", "short_title": "Review UIN Modifications", "action_item": "Review and verify that UIN modifications are allowed as per paragraph 67 of this document, including changes to premium rates/charges and/or benefit rates due to modifications." }, { "section_name": "", "short_title": "Verify Permitted Amendments without UIN", "action_item": "Verify that amendments without UIN modifications are allowed as per paragraph 68 of this document and are implemented through the use and file process." }, { "section_name": "", "short_title": "Check Premium Rate Changes", "action_item": "Check and verify that changes to premium rates/charges and/or benefit rates are properly documented and implemented, including those due to changes in mortality rates, interest rates, and expense rates." }, { "section_name": "", "short_title": "Review Benefit Rate Changes", "action_item": "Review and verify that changes to benefit rates, including those due to changes in mortality rates, interest rates, and expense rates, are properly documented and implemented." }, { "section_name": "", "short_title": "Verify Commission and Expense Changes", "action_item": "Verify that changes to commission and expense rates, including anticipated commission/payout/expenses, are properly documented and implemented." }, { "section_name": "", "short_title": "Check Policy Term and Premium Payment Changes", "action_item": "Check and verify that changes to policy terms and premium payment modes, including changes to premium tables and benefit rate tables, are properly documented and implemented." }, { "section_name": "", "short_title": "Review Minimum/Maximum Premium and Sum Assured Changes", "action_item": "Review and verify that changes to minimum/maximum premium and/or minimum/maximum sum assured/benefit rate are properly documented and implemented." }, { "section_name": "", "short_title": "Verify Introduction of New Unit-Linked Funds", "action_item": "Verify that the introduction of new unit-linked funds in existing unit-linked products is properly documented and implemented." } ]

[]

[ { "section_name": "", "short_title": "Review Policy Eligibility Criteria", "action_item": "Review and verify the policy eligibility criteria, including the type of lives covered, such as individual, group, or all types of lives, and the geographical location, such as specific regions in India or all of India." }, { "section_name": "", "short_title": "Verify Minimum and Maximum Sum Insured", "action_item": "Verify the minimum and maximum sum insured per person per year, as stated in the policy documents." }, { "section_name": "", "short_title": "Check Premium Details", "action_item": "Check the minimum and maximum premium amounts, including the payment method and coverage amount, as specified in the policy documents." }, { "section_name": "", "short_title": "Review Age Eligibility", "action_item": "Review and verify the minimum and maximum ages for policy entry, including the proximity to the next birthday." }, { "section_name": "", "short_title": "Verify Policy Term", "action_item": "Verify the minimum and maximum policy terms in years or months, as stated in the policy documents." }, { "section_name": "", "short_title": "Check Premium Payment Term", "action_item": "Check the minimum and maximum premium payment terms in years or months, as specified in the policy documents." }, { "section_name": "", "short_title": "Review Waiting Period", "action_item": "Review and verify the minimum waiting period in years, including the proximity to the next birthday." }, { "section_name": "", "short_title": "Verify Exclusions and Limitations", "action_item": "Verify the exclusions and limitations of the policy, including any restrictions on travel abroad or future employment." }, { "section_name": "", "short_title": "Review Policy Benefits", "action_item": "Review and verify the benefits payable under the policy, including the amount and conditions for payment." }, { "section_name": "", "short_title": "Check Policy Features", "action_item": "Check the features of the policy, including the type of coverage, such as individual or group, and any additional benefits or riders." } ]

[]

[]

[ { "section_name": "प्रमाणीकरण-VII: आईआरडीएआई (बीमा उ ाद) िविनयम, 2024 का अनुपालन न करने के कारण आशोिधत उ ादों और राइडरों का िववरण", "short_title": "Review IRDAI Compliance", "action_item": "Review the compliance of the organization with the IRDAI (Insurance Products) Regulations, 2024, specifically in relation to life insurance products, as per the guidelines and standards issued by IRDAI vide circular IRDAI/ACTL/MSTCIR/Various/89/6/2024 dated 12.06.2024." }, { "section_name": "प्रमाणीकरण-VII: आईआरडीएआई (बीमा उ ाद) िविनयम, 2024 का अनुपालन न करने के कारण आशोिधत उ ादों और राइडरों का िववरण", "short_title": "Verify Non-Compliant Products", "action_item": "Verify the list of insurance products and riders that have been discontinued due to non-compliance with the IRDAI (Insurance Products) Regulations, 2024, and check if the necessary actions have been taken to rectify the non-compliance." }, { "section_name": "प्रमाणीकरण-VII: आईआरडीएआई (बीमा उ ाद) िविनयम, 2024 का अनुपालन न करने के कारण आशोिधत उ ादों और राइडरों का िववरण", "short_title": "Check Regulatory Requirements", "action_item": "Check if the organization has adhered to the provisions and applicable standards of the IRDAI (Insurance Products) Regulations, 2024, and verify that all necessary documentation and records are maintained to demonstrate compliance." } ]

[]

[]

[]

[]