In exercise of the powers conferred by clauses (s), (t), (u), (v) and (vb) of sub-section 2 of section 114A read with Section 42D and 42E of the Insurance Act, 1938 (4 of 1938) and read with section 2(1)(f), 14 and 26 of the Insurance Regulatory and Development Authority Act, 1999 (41 of 1999), the Authority, in consultation with the Insurance Advisory Committee, hereby makes the following regulations, namely:
1.1 These Regulations may be called the Insurance Regulatory and Development Authority of India (Insurance Services by Common Service Centres) Regulations, 2015.
1.2 These Regulations shall come into force on the date of their publication in the Official Gazette.
PRELIMINARY
2.1 Act means the Insurance Act, 1938 (4 of 1938) as amended from time to time
2.2 Authority means the Insurance Regulatory and Development Authority of India established under the provisions of Section 3 of the Insurance Regulatory and Development Authority Act, 1999 (41 of 1999);
2.3 CSC means the Common Service Centre established under National e-Governance Plan by M/s CSC e-Governance Services India Limited.
2.4 CSC-SPV means M/s CSC e-Governance Services India Limited, the Special Purpose Vehicle (SPV) incorporated to facilitate delivery of government, private and social sector services to citizens of India through the Common Services Centres (CSCs) network, and approved by the Authority under these Regulations, who for remuneration arranges insurance contracts (under specific products approved by the Authority) with insurers on behalf of its clients and offers other insurance related services through CSC Network.
Explanation: CSC-SPV shall be an insurance intermediary for the purposes of Section 2(1)(f) of the IRDA Act, 1999.
2.5 CSC Product means the product marketed through the CSC Model and prefixed with the word CSC to clearly distinguish the product as Exclusive CSC Product .
2.6 Examination Agency which includes National Institute of Electronics and Information Technology (NIELIT), an autonomous scientific society of Department of Electronics and Information Technology, Government of India or any other agency approved by the Authority for the purpose of holding examinations for the CSC-SPV and the Rural Authorised Persons (RAPs).
2.7 Principal Officer of CSC-SPV means a person under the employment of CSC-SPV and nominated by the CSC-SPV to function as the Principal Officer of CSC-SPV.
2.8 Rural Authorized Person (RAP) is an individual Village Level Entrepreneur (VLE) Registered and Authorised by CSC-SPV to operate and manage a Common Service Centre, and approved by the Authority upon successful completion of training and examination, as specified by the Authority.
2.9 State Designated Agency (SDA) is the nodal agency at state level involved for monitoring and supervision of the CSC project progress at the state level.
2.10 Service Centre Agency (SCA) is the implementing Agency responsible for covering a group of districts in a state; providing the required investment budget and the functional specifications of the CSC.
2.11 Service Partner Agency includes SDA or SCA or any other agency under the CSC Scheme of Government of India.
2.12 Solicitation for the purpose of these regulations is defined as the approach to a prospect by a RAP with a view to enabling the prospect to purchase an insurance policy, and includes providing assistance in case the prospect decides to purchase an insurance policy.
2.13 Village Level Entrepreneur (VLE) is an individual registered and authorised to operate the Common Service Centre, who is in-charge of running the daily operations of the CSC, as approved by the SCA or SDA and CSC-SPV under CSC Model.
2.14 Words and expressions used and not defined in these Regulations but defined in the Insurance Act, 1938 (4 of 1938), as amended from time to time, the Insurance Regulatory and Development Authority Act, 1999 or in any of the Regulations and Guidelines made there under shall have the meanings respectively assigned to them in those Acts or Regulations or Guidelines.
REGISTRATION OF CSC-SPV
3.1 Applicant, CSC-SPV, desiring to obtain a Registration to act as an insurance intermediary shall follow the following procedure:
(a) Submit an application to the Authority in the Form A as specified in these Regulations.
(b) Remit non-refundable application fees of five thousand rupees plus applicable tax along with the application for grant of registration
(c) Submit all the necessary documents as mentioned in the application Form-A along with declaration from Principal Officer satisfying the fit & proper criteria specified in Schedule-I (Part-I).
3.2 An application, that is not complete in all respects and/or not conforming to the instructions specified in application form and/or not complying with the requirements and/or directions of the Authority, may be rejected.
Provided that, before rejecting any such application, the CSC-SPV shall be given a reasonable opportunity to complete the application in all respects and rectify the errors, if any.
4.1 The Authority on being satisfied that the applicant fulfils all the conditions specified for the grant of registration, shall grant a registration in Form-B and send intimation thereof to the CSC-SPV.
4.2 The registration shall be issued subject to the CSC-SPV adhering to the conditions and code of conduct as specified in Schedule IV.
4.3 A license granted to the CSC-SPV under the Guidelines on Common Service Centres issued by the Authority shall be valid till its expiry and shall thereafter apply for registration as per Regulation 3.
5.1 The registration issued under these Regulations shall be valid for a period of three years from the date of its issue, unless it is suspended or cancelled by the Authority.
5.2 CSC-SPV shall not be allowed to function as such after the expiry of registration unless it is renewed by the Authority.
5.3 In case the registration of the CSC-SPV is cancelled or suspended or not renewed the policyholders shall be serviced by the insurers.
6.1 CSC-SPV shall submit the application for renewal of registration to the Authority in Form-A at least thirty days before the expiry of the registration. However, the CSC-SPV is permitted to apply for renewal ninety days before the expiry of the registration.
6.2 The documents to be submitted by the CSC-SPV along with the renewal application form are mentioned in the renewal Application Form-A.
6.3 The applications for renewal of registration shall be submitted along with a renewal fee of Rs. One thousand only plus service tax. The CSC-SPV shall pay late fee of Rs. Five hundred, if the application for renewal of the registration does not reach the Authority at least thirty days before the date of expiry of registration.
Provided that the Authority may condone the delay beyond 30 days for submission of renewal application for sufficient reasons offered in writing by the CSC-SPV for a delay not covered by the previous proviso and accept an application for renewal after the date of the expiry of the registration on payment of an additional fee of one thousand rupees only by the CSC-SPV.
6.4 The Authority may call for any additional information/documents as deemed fit for processing the renewal application, from the CSC-SPV.
6.5 The Authority, on being satisfied that the CSC-SPV fulfils all the conditions specified for renewal of the registration, shall renew the registration in Form-B.
6.6 The renewal of Registration shall be valid for a period of three years.
INSURANCE SOLICITATION AND FUNCTIONS OF CSC-SPV AND RAP
7.1 For the purpose of solicitation of insurance business, Rural Authorized Person (RAP) is authorized.
7.2 CSC-SPV shall be responsible for all acts of commission and omission of the RAPs deployed on their behalf.
7.3 Rural Authorized Person (RAP) shall possess minimum qualification as specified in Schedule-I, Part-III.
7.4 The Training, examination and certification of RAP shall be as specified in Schedule-I, Part-IV.
7.5 Code of Conduct for Rural Authorised Person is stipulated in Schedule-IV.
8.1 The CSC-SPV's Portal shall enable any RAP to register insurance business in the CSC-SPV's Portal only after the RAP passes the examination, the registering authority issues the registration certificate to the RAP, and the registration number and validity period of the registration are updated in the CSC-SPV's Portal.
8.2 In case there is a change in VLE in case of a CSC; the new VLE may carry out insurance servicing from the date of appointment as VLE. However, the VLE can register New Business only from the date he is issued necessary certificate under Regulation 7 of these regulations.
The functions of CSC-SPV are given in Schedule-II, Part-I.
10.1 The functions of Rural Authorised Person are given in Schedule-II, Part-II.
10.2 Obligations pertaining to RAP are given in Schedule-II, Part-III.
11.1 The remuneration payable to CSC-SPV by the Insurer, for solicitation of policies by the RAPs shall be as per the regulations issued by the Authority on payment of commission or remuneration.
11.2 The remuneration payable to the CSC-SPV by the insurer, for other services shall be as mutually agreed between the insurer and CSC-SPV from time to time.
11.3 CSC-SPV, on receipt of any remuneration from the insurer, shall distribute not less than 80% of the same to the respective RAPs. The remuneration to entities such as SDA or SCA or service partner agency shall be as per the agreement with the insurer after retaining an amount of not exceeding 8% towards fees for recruitment, providing and enabling the software, guiding and monitoring the RAP in day to day functions.
11.4 The commission or remuneration, if any, to be paid to the CSC-SPV shall be as per the bifurcation given bellow:
(a) Commission to the CSC-SPV towards solicitation and to procure new business.
(b) Service charges for post sale service of the policy.
11.5 CSC-SPV shall enter into an agreement with the insurers and mention clearly in the agreement the percentages and method of distribution of the remuneration to various entities in the CSC Model.
11.6 The settlement of accounts by insurers in respect of remuneration of CSC-SPV shall be done on a monthly basis and it shall ensure that there is no cross settlement of outstanding balances.
The Insurers may market certain categories of Retail Insurance policies for individuals only and offer insurance related services through the CSCs. The on-boarding charges allowed shall be as follows:
12.1 CSC-SPV On-Boarding Corpus Fund shall be set up with initial contribution of Rs. Twenty Lakh from each insurer, which has entered into an agreement with CSC-SPV for distribution of its Insurance product through the CSCs.
12.2 The Insurer signing the agreement shall pay the installment equally in four quarters.
12.3 The on boarding Corpus Fund shall be maintained in an Escrow Account called the CSC-SPV On-boarding Corpus Fund operated by the Life Insurance Council.
12.4 The amount fixed towards On-boarding charges per CSC activated shall be Rupees Five Thousand which may be revised from time to time.
12.5 CSC-SPV shall submit to the Life Insurance Council and General Insurance Council, the list of CSCs that are activated to undertake Insurance operations and seek release of the On-boarding charges. The list shall be made available on the Councils website for information and transparency
12.6 Life and General Insurance Councils shall maintain separate account codes and Book of accounts in respect of the CSC-SPV On-boarding Corpus Fund which shall be inspected by the Authority and audited by a qualified auditor annually.
13.1 Insurers shall develop insurance products to be marketed exclusively through the CSC Model and file such products with the Authority for approval.
13.2 The products developed for CSC Model shall not have the Sum Assured (per life or risk) exceeding rupees two lakhs, except for motor insurance. Such products approved by the Authority for the CSC Model shall be marketed only through the CSC Model.
13.3 The types, procedure and conditions for insurance products developed for CSC Model are given in Schedule-III.
An Agreement or a Service Level Agreement or Memorandum of Understanding shall be entered between the insurers and CSC-SPV. The agreement shall cover procedures and other functions of the CSC-SPV as follows:
14.1 Procedures for:
(a) enabling or disabling the RAP for the delivery of the approved insurance products;
(b) tracking and monitoring the transactions and activities of the RAP;
(c) incorporating the Unique code allotted by CSC-SPV;
(d) incorporating the Aadhaar number of the customer and nomination.
(e) sending the soft copy of the proposal data, claims data and any other information by the RAP to the Insurer.
(f) sending the soft copy of the completed policy data, claims data and any other information by the Insurer to the RAP.
(g) sending the soft files and documents relating to claims of the insured to Insurer.
(h) hard copy of the claims related documents to insurers.
(i) maintenance of data in a secure mode by the Insurer.
(j) updation and transmission of data in a secure mode by the Insurer.
14.2 The PAN number of RAP may be used by all insurers to maintain uniformity.
14.3 Tracking code may be agreed mutually by insurers and CSC-SPV
14.4 List of Products to be marketed through the CSC-SPV.
14.5 A robust grievance redressal system should be set in at both the CSC-SPV level and the insurer level. The insurers should submit a Complaint Redressal Analysis report to the Authority every quarter.
14.6 The CSC-SPV and the Insurers shall develop suitable system to ensure continuity in the services rendered by RAP to policyholders, even after the termination of agreement with registered RAP.
14.7 The method of distribution of remuneration received from the insurer by the CSC-SPV as mentioned in Regulation 11.
14.8 The roles and obligations of the parties, including the Service Partner Agency to the agreement.
14.9 The code of conduct of CSC-SPV, and RAP specified in Schedule-IV.
Obligations of Insurer are specified given in Schedule-V, Part-III.
The Insurer and the CSC-SPV shall submit periodical reports to the Authority as specified hereunder.
16.1. CSC-SPV shall furnish to the Authority Quarterly report in Form-D, Form-E, Form-F and any other return, as may be, required by the Authority on Insurance activities.
16.2. Insurers shall furnish to the Authority half yearly report in Form-G and any other return, as may be, required by the Authority on business procured through RAPs.
The Authority may appoint one or more of its officers as inspecting authority to undertake inspection of the premises of the CSC-SPV or CSCs to ascertain the activities of CSC-SPV, and also to inspect the books of accounts, records and documents of the CSC-SPV and RAP for any of the purposes specified in these guidelines; and
(a) to ensure the compliance of provisions of the Act, Rules and Regulations;
(b) to investigate the complaints received from any insured, or insurer, or any other person on any matter having a bearing on the activities of the RAP or CSC-SPV; and
(c) to investigate the affairs of the RAP or CSC-SPV suo moto in the interest of proper development of insurance business or in the policy holders' interest.
The procedure to be followed by the Authority in the event of CSC-SPV & RAP violating any of the provisions of the IRDA Act, Regulations, Guidelines, Circulars, Notifications shall be as specified in Schedule VI of these Regulations.
Suspension or cancellation of registration shall be as given in Schedule VI of these Regulations.
In order to remove any difficulties in respect of the application or interpretation of any of the provisions of these Regulations, the Chairperson of the Authority may issue appropriate clarifications from time to time.
Application for Grant of Registration/Renewal of Registration (Regulation 3.1(a), 6.1 & 6.2)
| NAME OF THE APPLICANT |
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___________________________________________ |
| CONTACT ADDRESS |
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__________________________________________ |
| __________________________________________ |
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| __________________________________________ |
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| __________________________________________ |
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| __________________________________________ |
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| __________________________________________ |
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| TELEPHONE NO. |
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__________________________________________ |
| MOBILE NO. |
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__________________________________________ |
| FAX NO. |
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__________________________________________ |
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__________________________________________ |
| __________________________________________ |
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| __________________________________________ |
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| __________________________________________ |
It is important that before this application form is filled in, the Regulation issued by the Authority are studied carefully.
Applicant must submit a duly completed application form together with all appropriate, supporting documents to the Authority.
Application for registration will be considered only if it is complete in all respects.
Applicants should sign the applications themselves.
Information which needs to be supplied in more details may be given on separate sheets which should be attached to the application form.
1.1 Name of the Applicant:
1.2 Address-Principal Place of business/Registered Office.
| Pin Code: |
Email: |
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| Tel No: |
Fax No: |
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| Mobile No: |
** (Attach List of Addresses of Branch Offices if any)
Name and Designation of the Principal Officer
Status of the Applicant:
(Limited company-Private/Public, Others. If listed, names of Stock Exchanges to be given)
| Name of the company |
Status |
Date of Incorporation (DD/MM/YYYY) |
Place of Incorporation |
Name of stock exchanges where listed |
3.1 Three years business plan document with projected volume of activities and income (including anticipated) for which registration sought is to be specifically mentioned and attached to this application.
3.2 Organisation Chart separately showing functional responsibilities to be enclosed
3.3 Particulars of Key Management Personnel
| Name |
Designation/Position |
Qualification |
Experience |
Date of Appointment |
Functional Area |
3.4 Any other information considered relevant to the nature of services rendered by the applicant.
| Capital Structure |
(Rs. in lakhs) |
| S No |
Capital Structure |
Preceding year (X-2) |
Preceding year (X-1) |
Preceding year (X) |
| (a) |
Authorized Capital and issued capital |
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| (b) |
Paid-up capital |
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| (c) |
Free Reserves (Excluding Revaluation reserves) |
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| (d) |
Total (b) + (c) |
Note: Please enclose three years audited annual accounts. If minimum capital requirement has been met after last audited annual accounts, audited statement of accounts for the period ending on a later date should also be submitted.
5.1 Details of all settled and pending disputes: (Attach separate sheet and give full information in the format shown below)
| Nature of dispute |
Name of the party |
Pending/settled |
** Attach sheet if required
5.2 Details, if any of any economic offences by the applicant or any of the Directors or key managerial Personnel in the last three years.
For and on behalf of
___________________________________________
| Principal Officer |
CEO/Managing Director |
| (Signature and Name of Applicant) |
(Signature & Name of Applicant) |
| (Block Letters) |
(Block Letters) |
Place:
Date:
In exercise of the powers conferred by sub-section (1) of section 42D of the Insurance Act, 1938 (4 of 1938) the Authority hereby grants a registration to
to act as Authorised Intermediary to market the specifically approved insurance products through the Rural Authorised Persons (Village Level Entrepreneurs) under CSC Model under the IRDAI (Insurance Services by Common Service Centres) Regulation, 2015.
Registration Code granted is
1. This certificate of registration shall be valid from _____________to_________
This certificate of registration is subject to the Act, Insurance Regulatory and Development Authority Act, 1999 (4 of 1999) and the IRDAI (Insurance Services by Common Service Centres) Regulation, 2015.
2. and shall not be construed to be in compliance with or in conformity to any other Act, rules or regulations.
Place:
By Order
Date: __________
For and on behalf of
Insurance Regulatory and Development Authority of India
| Name of the Insurer |
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___________________________________________ |
| Return for the quarter ending |
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___________________________________________ |
| No. Of products marketed at the beginning of the quarter |
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___________________________________________ |
| No. Of products added during the quarter |
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___________________________________________ |
| No. Of products withdrawn during the quarter |
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___________________________________________ |
| No. Of products marketed at the end of the quarter |
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___________________________________________ |
| S. No. |
Product Name |
Product Category |
IRDA Approval No. (UIN) |
Date of commencement |
Date of withdrawal |
Date:
Place:
Signature
Name & Designation of Authorised Signatory
(To be furnished in spread sheet format to the Authority by CSC-SPV)
(Regulation 16.1)
| Details |
No. of Life Insurers |
No. of Non Life Insurers |
No. of Life Products |
No. of Non Life Products |
No. of RAPs |
| At the beginning of the quarter |
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| Additions during the Quarter |
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| Deletions during the Quarter |
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| Active at the end of the quarter |
Date:
Place:
Signature
Name & Designation of Authorised Signatory
(To be furnished in spread sheet format to the Authority by CSC-SPV)
(Regulation 16.1)
| S No. |
Name of RAP (Village level Entrepreneur) |
IRDAI Certificate number |
Date of passing the Examination |
No. of Policies procured |
Net premium procured |
Remuneration received for premium Procured by the RAP during the period. |
Remuneration received for rendering other services by the RAP during the Period. |
Net Premium means (Gross premium less Service Tax)
Date:
Signature of Principal Officer of CSC-SPV
(To be furnished in spread sheet format to the Authority by CSC-SPV)
| S. No |
Name of RAP (Village level Entrepreneur) |
IRDAI Registration number |
PIN code of the location of RAP |
No. of Policies procured |
Net premium income during the period |
No. of Claims paid |
Claim Amount Paid |
Date:
Signature of Principal Officer of CSC-SPV
(To be furnished in spread sheet format to the Authority by Insurer)
Due date of the return: 15th November and 15th May every year.
During the half-yearly period/Cumulative details during the Year*:
| Details of business |
State 1 |
State 2** |
| Total No. of policies issued |
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| Total premium collected |
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| Total commission paid |
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| Total service charges paid |
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| Total No. of policies discontinued after the grace period |
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| Total No. of policies revived during the period |
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| Total No. of policies surrendered |
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| Total No. of claims incurred |
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| Total No. of claims settled |
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| Total No. of claims outstanding |
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| Total No. of claims rejected |
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| Total in force at the end of the period |
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| Total charges levied (for Variable Insurance Product) |
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| Total interest credited (for Variable Insurance Product) |
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| Totals amount in the Individual Policy Accounts at the beginning of the year |
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| Total amount in the Individual Policy Accounts at the end of the Year |
*The details shall be given for the half year and for the year also separately.
** The details shall be given for each State separately.
Signature of the AA
Signature of the CEO
Date:
Schedules & Forms
1) The Principal Officer of the CSC-SPV seeking registration shall be considered as a fit and proper person , if he fulfills the conditions, including, but not limited to the following criteria
(a) Has not committed an offence involving financial integrity;
(b) Has not been convicted for any criminal offence or civil liabilities;
(c) Has requisite qualifications and experience;
(d) Has good track record; and
(e) absence of any disqualification to act as an insurance intermediary as stipulated in the Act.
1) It should be established by the Government of India
2) It should be under National e-Governance Plan (NeGP)
1) Pass in 10th Class or equivalent examination from a recognized Board/Institution.
2) Minimum knowledge of Computer applications/operations.
3) Should have completed at least 20 hours of theoretical training from an institution recognized approved by the Authority from time to time.
4) Should pass an examination, at the end of the period of training mentioned above conducted by the NIELIT (National Institute of Electronics and Information Technology) or any other examination agency approved by the Authority from time to time.
5) The syllabus for the above training shall cover Principles and Practice of Insurance, Legal aspects of Insurance; AML/PML & KYC, General Insurance and Life Insurance, as specified by the Authority from time to time.
Training & Methodology, Examination and Certification of Rural Authorised Person (RAP)(Regulation 7.4) Training & Methodology:
1) The VLE shall undergo 20 hours training covering the topics stated in the specified Syllabus.
2) The training material and self assessment content shall be in digital downloadable format and shall be hosted under a suitable Learning Management System by CSC-SPV or any other institution as recognised/approved by the Authority from time to time.
3) The self-assessment tests shall be in multiple-choice models
4) The VLE shall register on the Learning Management System website designed by CSC-SPV and complete the training.
5) The VLE shall download the digital training content to his Personal Computer or Laptop and complete the self-learning modules. In this regard, CSC-SPV shall issue necessary certification.
6) At the end of each module the VLE shall complete the self-assessment test. The Learning Management System shall not allow the VLE to complete more than two self-assessment test per day.
7) On completion of the self-assessment test for each of the module, the candidate shall earn one-hour training credit.
8) The VLE shall complete all the 20 self-learning modules and self assessment tests online to earn the credit for 20 hours training.
Examination and Certification:
1) The online examination of RAP shall be conducted by NIELIT or any other examination agency as approved by the Authority from time to time in their centres spread across India.
2) The VLE on completion of training and earning 20 hours training credit shall be eligible for appearing for the online examination.
3) The periodicity of the online examination shall be decided by the Authority in consultation with respective examination agency, depending on the requirements.
4) The examination questions shall be displayed with multiple choices of answers.
5) The number of questions for the online examination shall be 40 and with a duration of 60 minutes.
6) Each question shall carry 2.5 marks and the examination is for 100 marks. The examinee has to score minimum 35 marks to pass the examination.
7) There will not be any negative marks for wrong answers.
8) There shall be no limit for the number of attempts for appearing the examination by VLE
9) The VLE has to pay the appropriate fee as approved by the Authority for training and examination to the concerned institutes.
10) On passing the examination, the examination agency shall issue a certificate of passing of the examination by VLE
11) The Certification of the completion of training and passing the examination shall be valid only during the period the RAP is authorised to manage operations of the CSC. The certificate is no longer valid as soon as the services of RAP are terminated or suspended by CSC-SPV or its authorised service partner agency.
Online Examination:
1) Online examination shall be conducted by examination agency and the results will be published on the CSC-SPV's Website and copy sent to the Authority.
2) VLEs who are declared pass in the examination shall be issued a Certificate to solicit insurance business and shall be referred to as Certified for procuring Insurance Business under CSC Model
3) Insurers shall register New Business of only such RAPs who are listed in the CSC-SPV's Portal as Certified for procuring Insurance Business under CSC Model . Insurers shall under no circumstance register New Business from a RAP who is NOT CERTIFIED by the examination agency to carry out Insurance business.
(a) CSC-SPV, on valid registration from the Authority to act as an insurance intermediary, may enter into agreements with Insurers as specified in Regulation 14 of these regulations.
(b) CSC-SPV shall assist the VLEs to undergo the prescribed training and certification as specified in Schedule-I.
(c) CSC-SPV may obtain the support of the service partner agency in training the VLE, providing operational and marketing support and guidance in field operations of the RAP as deemed fit. The agreement entered with the insurers shall specify the details of the support enlisted.
(d) On successful completion of training and passing the prescribed examination and based on the certificate issued by examination agency to a RAP, CSC-SPV shall enter into an agreement with the RAP authorising him to solicit the approved insurance products.
(e) CSC-SPV shall include the relevant conditions and clauses as prescribed by the Authority for the compliance of these regulations including the prescribed code of conduct for a RAP, in the agreement entered into with RAPs.
(f) CSC-SPV shall ensure continuous monitoring of the activities of the RAPs and be responsible for the compliance of these regulations and the code of conduct by RAPs.
(g) CSC-SPV shall maintain a copy of agreement entered with each insurer.
Insurance related functions of a RAP shall include the following:
(a) Assisting the prospects to select the policy based on the need of Insurance.
(b) Obtaining detailed information relating to proposers/persons/risks to be insured and protection needs and render advice on appropriate insurance cover.
(c) Providing the insurer with underwriting information like age, income, family medical history, any illness suffered and such other information as required in assessing the risk.
(d) Acting promptly on instructions from a client and providing him written acknowledgements and information on proposal acceptance and status of claims settlement.
(e) Assisting clients in paying premium, in compliance with section 64VB of the Insurance Act, 1938 as amended from time to time.
(f) Advise and assist clients in effecting nomination, assignment and other policy services, and inform insurers about changes like, change in residential address, change in nomination, sale of vehicle etc. For updation and arrange to get necessary endorsement in the policy documents if required.
(g) Assist and facilitate claims settlement process by helping insured in filling claim form, collect copy of documents like death certificate, nomination, assignment, and such other documents required for settlement of claims by insurers.
(h) Inform clients about payment of renewal premium and send policy renewal notices to clients on behalf of insurers, if the insurer outsources the services.
(i) Comply with the AML/KYC guidelines issued by the Authority from time to time.
(j) All other customer centric services as may be required for smooth and effective policy servicing.
1) The agreement between the CSC-SPV and the RAP shall include:
(a) Code of Conduct for RAPs.
(b) Adherence to regulatory provisions, compliances, disclosures, ethical conduct of business and specific instructions that are issued by the authority from time to time.
(c) Adherence to the provisions of the IRDA Act, 1999.
2) Subject to reference to Regulation 10.2 above, RAP will also be held responsible for any act of omission or commission in the insurance business transactions undertaken by him.
(a) In the process of soliciting insurance business and providing claims service RAP shall ensure compliance of KYC norms, AML guidelines, and regulations, disclosure norms, guidelines issued by the Authority from time to time in this regard.
(b) RAP is barred from soliciting insurance and offering any other insurance business related services in their individual capacity, in any mode, on behalf of any individual, organization, or insurer, other than the CSC Model.
(c) RAP shall maintain the records and the reports of the activities related to Insurance, in the manner specified in the appointment agreement with CSC-SPV.
(d) RAP shall not accept any payment from Insurers other than the remuneration as specified in the agreement between the Insurer and the CSC-SPV.
3) Every RAP shall, with a view to conserve the insurance business already procured through him, make every attempt to ensure remittance of the premiums by the policyholders within the stipulated time, by giving appropriate notice to the policyholder.
Insurer shall comply with the following:
1) The product to be marketed through the CSC Model shall be prefixed with the word CSC to clearly distinguish the product as Exclusive CSC Product .
2) Every insurer shall file the products under the current File and Use procedure for distribution under this channel. The insurer shall take into account the following additional requirements for filing the products under this distribution channel:
(a) Name as specified in (1) above
(b) Copy of the on-line e-proposal form to be used in the CSC Center with Aadhaar identification.
(c) Copy of the Policy document to be printed in A4 stationary at the CSC Center with e-policy stamping/e-signature etc.
(d) Copy of the Policy Servicing Manual along with the forms to be used such as
(i) Nomination Form
(ii) Change of Nomination Form
(iii) Assignment Form
(iv) Revival Form
(v) Partial Withdrawals Form
(vi) Survival Benefits Form/Death Claim Form
(vii) Maturity Claim Form
(viii) Any other form that the insurer will require for servicing the Policy for each of the products filed with the Authority.
3) The CSC-SPV shall provide/arrange various services to the insurer in accordance with the agreement, where the services shall be in compliance with the outsourcing guidelines issued by the Authority. The File and Use application for each product shall specify the service charges for each of the services applicable to the product.
4) The insurers shall be allowed to accept the insured's/policyholder's biometric thumb impression on the proposal form and biometric IRIS instead of obtaining a wet signature on the proposal form, as his/her consent of the proposal form.
5) The CSCs, on behalf of the insurers, shall be allowed to print the policy document on a plain A4 size paper, as proof of a valid policy for such products.
6) The insurer is encouraged to hold the policy documents i.e. e-policy in the Demat form with any of the registered Insurance Repositories.
7) Every insurer at the time of filing of the product shall also file the Policy Service Manual for policy distributed through CSCs approved by the Board or the Board delegated risk committee of the insurer and include:
(i) Detailing the process to be followed for each of the service to be provided by the CSC,
(ii) the corresponding process followed by the insurer to complete the policy servicing,
(iii) the turnaround times for each type of service,
(iv) Service charge for each type of the service.
(v) The policy servicing details may include:
(a) Process for printing of the policy
(b) Process for printing of endorsement
(c) Process for collection of premiums and remittance to insurers
(d) Process for change of address
(e) Process for Assignment/Nomination/Change of Nomination
(f) Process for assisting in revival
(g) Process for Partial Withdrawals
(h) Process for Surrender Benefit Claims
(i) Process for Death Claims
(j) Process for Maturity Claims
(k) Processes for other Service operations as may be specific for the products.
8) Any amendments to the Policy Service Manual duly approved by the Board or Board delegated risk committee of the insurer shall be filed with the Authority.
9) The insurers shall offer any of the following products under the CSC Model:
(i) Non-Participating Non-Linked Variable Insurance Products with regular premium payment;
(ii) Pure Term Insurance Products with regular premium payment;
(iii) Any other type of product that may be specifically permitted by the Authority.
10) The products referred in the point (9) above shall have the features as specified by the Authority.
11) The features of products at 9(i)&(ii) specified by the Authority vide its circular no IRDA/Life/CIR/GDL/044/01/2014 dated 28th January, 2014 shall continue to be valid.
12) The CEO and the AA shall certify that the product filed is compliant with the above requirements along with the File and Use Application form.
13) In this regard, the insurers shall submit on a half yearly basis the returns as prescribed in Form G.
(a) The general insurance products that may be sold through the CSC Model are as follows:
(i) Personal Accident Insurance
(ii) Cattle/Livestock Insurance
(iii) Agricultural Pump set Insurance
(iv) Farmer's package policy
(v) Fire & Allied Peril Dwellings Insurance
(vi) Motor Insurance
(vii) Health Insurance
(viii) Any other type of product that may be specifically permitted by the Authority.
(b) The above mentioned products marketed through CSC by the insurers subject to the following conditions:
(i) Filing of the letter of intent along with copy of agreement with CSC-SPV to the Authority in respect of the product proposed to be offered
(ii) The premium charged under the product as well as other terms will be exactly as per the considered product by the Authority under F&U guidelines.
(iii) The maximum commission payable in respect of the above products shall be as per the regulations on payment of commission or remuneration to agents and insurance intermediaries issued by the Authority.
(iv) The maximum Sum assured to be offered under these products shall be limited to Rs. 2 Lakhs. Provided that in case of package policies, sum insured limit of Rs. 2 lakhs shall exclude sum insured for motor insurance.
(v) There is a strict compliance of all relevant rules and regulations issued by the Authority in general and 64VB in particular.
(vi) The products referred in the point (2) above shall have the features as specified by the Authority.
1. CSC-SPV shall follow recognised standards of professional conduct and discharge their functions in the interest of the policyholders.
2. Conduct in matters relating to clients relationship. The CSC-SPV through the RAP shall:
(a) conduct its dealings with clients with utmost good faith and integrity at all times;
(b) act with care and diligence;
(c) ensure that the client understands their relationship with the CSC-SPV;
(d) treat all information supplied by the prospective clients as completely confidential to themselves and to the insurer(s) to which the business is being offered;
(e) take appropriate steps to maintain the security of confidential documents in their possession;
(f) understand the type of client it is dealing with and the extent of the client's awareness of risk and insurance;
(g) avoid conflict of interest.
(h) obtain necessary documents required under KYC norms
3. Conduct in matters relating to Sales practices. The CSC-SPV through the RAP shall:
(a) confirm that he does not employ agents or canvassers to bring in business;
(b) identify itself and explain as soon as possible the degree of choice in the products that are on offer;
(c) ensure that the client understands the type of service it can offer;
(d) offers a policy that is suitable to the needs of the prospective client;
(e) give advice only on those matters in which it is knowledgeable and seek or recommend other specialist for advice when necessary;
(f) not make inaccurate or unfair criticisms of any insurer;
(g) show, wherever possible, why a policy or policies are proposed and provide comparisons in terms of price, cover or service where there is a choice of products;
(h) explain the procedures to follow in the event of a loss.
(i) Not indulge in any sort of money laundering activities.
(j) ensure that the CSC-SPV does not indulge in sourcing of business by themselves or through call centers by way of misleading calls or spurious calls.
4. Conduct in relation to furnishing of information. The CSC-SPV through the RAP shall:
(a) ensure that the consequences of non-disclosure and inaccuracies are pointed out to the prospective client;
(b) avoid influencing the prospective client and make it clear that all the answers or statements given are the latter's own responsibility. Ask the client to carefully check details of information given in the documents and request the client to make true, fair and complete disclosure where it believes that the client has not done so and in case further disclosure is not forthcoming it should consider declining to act further;
(c) explain to the client the importance of disclosing all subsequent changes that might affect the insurance throughout the duration of the policy; and
(d) disclose on behalf of its client all material facts within its knowledge and give a fair presentation of the risk.
5. Conduct in relation to explanation of insurance contract. The CSC-SPV through the RAP shall:
(a) provide the list of insurer(s) participating under the insurance contract and advise any subsequent changes thereafter;
(b) explain all the essential provisions of the cover afforded by the policy recommended by him so that, as far as possible, the prospective client understands what is being purchased;
(c) draw attention to any warranty imposed under the policy, major or unusual restrictions, exclusions under the policy and explain how the contract may be cancelled;
(d) notify changes to the terms and conditions of any insurance contract and give reasonable notice before any changes take effect;
6. Conduct in relation to renewal of policies. The CSC-SPV through the RAP shall ensure that its client is aware of the expiry date of the insurance;
7. Conduct in relation to claim by client. The CSC-SPV through the RAP shall:
(a) explain to its clients their obligation to notify claims promptly and to disclose all material facts and advise subsequent developments as soon as possible;
(b) request the client to make true, fair and complete disclosure where it believes that the client has not done so;
(c) give prompt advice to the client of any requirements concerning the claim;
(d) forward any information received from the client regarding a claim or an incident that may give rise to a claim without delay;
(e) advise the client without delay of the insurer's decision or otherwise of a claim; and give all reasonable assistance to the client in pursuing his claim. Provided that the CSC-SPV shall not take up recovery assignment on a policy contract which has not been serviced through him or should not work as a claims consultant for a policy which has not been serviced through him;.
8. Conduct in relation to receipt of complaints. The CSC-SPV through the RAP shall:
(a) ensure that letters of instruction, policies and renewal documents contain details of complaints handling procedures;
(b) accept complaints either by phone or in writing ensure that they are sent to the insurer at the earliest;
(c) ensure that response letters are sent and inform the complainant of what he may do if he is unhappy with the response;
9. Conduct in relation to documentation. The CSC-SPV through the RAP shall:
(a) ensure that any documents issued comply with all statutory or regulatory requirements from time to time in force;
(b) make available, with policy documentation, advice that the documentation shall be read carefully and retained by the client;
(c) acknowledge receipt of all monies received in connection with an insurance policy;
(d) ensure that the reply is sent promptly or use its best endeavours to obtain a prompt reply to all correspondence;
10. Conduct in matters relating to advertising. The CSC-SPV shall conform to the relevant provisions of the Insurance Regulatory and Development Authority (Insurance Advertisements and Disclosure) Regulations, 2000, and:
(a) ensure that statements made are not misleading or extravagant;
(b) where appropriate, distinguish between contractual benefits which the insurance policy is bound to provide and non-contractual benefits which may be provided;
(c) ensure that advertisements shall not be restricted to the policies of one insurer, except where the reasons for such restriction are fully explained with the prior approval of that insurer;
(d) ensure that advertisements contain nothing which is in breach of the law nor omit anything which the law requires;
(e) ensure that advertisement does not encourage or condone defiance or breach of the law;
(f) ensure that advertisements contain nothing which is likely, in the light of generally prevailing standards of decency and propriety, to cause grave or widespread offence or to cause disharmony;
(g) ensure that advertisements are not so framed as to abuse the trust of clients or exploit their lack of experience or knowledge;
(h) ensure that all descriptions, claims and comparisons, which relate to matters of objectively ascertainable fact shall be capable of substantiation.
11. Conduct in matters relating receipt of remuneration. The CSC-SPV though the RAP shall:
(a) advise the client in writing of the insurance premium;
(b) if requested by a client, disclose the amount of remuneration or other remuneration it receives as a result of effecting insurance for that client. This will include any payment received as a result of securing on behalf of the client any service additional to the arrangement of the contract of insurance; and
(c) advise its clients, prior to effecting the insurance, of their intention to make any deductions from the amount of claim collected for a client, where this is a recognised practice for the type of insurance concerned.
12. Conduct in relation to matters relating to training. The CSC-SPV shall:
(a) ensure that its staff are aware of and adhere to the standards expected of them by this code;
(b) ensure that staff are competent, suitable and have been given adequate training;
(c) ensure that there is a system in place to monitor the quality of advice given by its staff;
(d) ensure that RAPs are aware of legal requirements including the law of agency affecting their activities; and only handle classes of business in which they are competent;
(e) draw the attention of the client to Section 41 of the Act, which prohibits rebating and sharing of commission.
13. A CSC-SPV shall ensure that every RAP shall display in every office where it is carrying on business and to which the public have access a notice to the effect that a copy of the code of conduct is available upon request and that if a member of the public wishes to make a complaint or requires the assistance of the Authority in resolving a dispute, he may write to the Authority.
14. A CSC-SPV as defined in these regulations shall not act as an insurance agent of any insurer under section 42 of the Act.
15. CSC-SPV shall abide by the provisions of the Insurance Act, 1938 (4 of 1938), Insurance Regulatory And Development Authority Act, 1999 (41 of 1999), rules and regulations made there under which may be applicable and relevant to the activities carried on by them as CSC-SPVs.
Every Rural Authorized Person shall:
(1) Conduct his dealings with clients with utmost good faith and integrity at all times;
(2) Act with due care and diligence;
(3) Identify himself as a Rural Authorised Person and produce the Registration/Certificate to the prospect on demand.
(4) Disseminate the requisite information in respect of insurance products offered for sale and take into account the needs of the prospect while recommending a specific insurance plan to the prospective client;
(5) Treat all information supplied by the prospective clients as completely confidential to themselves and to the insurer(s) to which the business is being offered;
(6) Disclose the scales of remuneration in respect of the insurance product offered for sale, if asked by the prospect;
(7) Indicate the premium to be charged by the insurer for the insurance product offered for sale;
(8) Explain to the prospect the nature of information required in the proposal form by the insurer, and also the importance of disclosure of material information in the purchase of an insurance contract;
(9) Bring to the notice of the insurer any adverse health conditions, personal habits or income inconsistency of the prospect, in the form of a report (called Confidential Report ) along with every proposal submitted to the insurer;
(10) Ensure that the consequences of non-disclosure and inaccuracies are pointed out to the prospective client;
(11) Inform promptly the prospect about the acceptance or rejection of the proposal by the insurer;
(12) Advise every individual policyholder to effect nomination or assignment or change of address or exercise of options, as the case may be, and offer necessary assistance in this behalf, wherever necessary;
(13) Render necessary assistance to the policyholders or claimants or beneficiaries in complying with the requirements for settlement of claims by the insurer;
(14) Forward any information received from the client regarding a claim or an incident that may give rise to a claim without delay;
(15) Advise the client without delay of the insurer's decision or otherwise of a claim; and give all reasonable assistance to the client in pursuing his claim;
(16) Ensure that statements made regarding the policies to the customer are not misleading or extravagant;
(17) Ensure the compliance of Section 64-VB (4) of the Act;
(18) Draw the attention of the client to Section 41 of the Act, which prohibits rebating and sharing of commission/remuneration;
(19) Ensure the compliance of Anti Money Laundering and Know Your Customer guidelines in force.
(20) No RAP shall
(a) Solicit or procure insurance business without holding a valid registration certificate;
(b) Induce the prospect to omit any material information in the proposal form;
(c) Induce the prospect to submit wrong information in the proposal form or documents submitted to the insurer for acceptance of the proposal;
(d) Behave in a discourteous manner with the prospect;
(e) Interfere with any proposal introduced by any other insurance agent or other insurance intermediaries;
(f) Offer different rates, advantages, terms and conditions other than those offered by the insurer;
(g) Demand or receive a share of proceeds from the beneficiary under an insurance contract;
(h) Force a policyholder to terminate the existing policy and to effect a new proposal from him within three years from the date of such termination;
(a) Insurer shall not pay any fee or remuneration, by whatever name called, other than the remuneration as specified in the Regulation 11 of these regulations.
(b) Product specific training process should be set in place by the Insurer for training of the RAPs, and data on the training imparted during the quarter should be maintained by the Insurer to be submitted to the Authority as and when called for.
(c) Develop suitable systems to redress customer grievances/complaints.
(d) Develop simple insurance products, which are easy to understand by the RAPs and rural customers and other lower income segments and file the same with the Authority for approval.
(e) Insurers should submit a quarterly statement in Form-C giving details of all products marketed by CSC-SPV.
(f) Develop suitable feedback mechanisms to bring in improvements in the services rendered, effect changes, if any, required in the policy terms and conditions.
(g) Develop suitable system to ensure continued insurance protection and servicing to rural customers.
(h) Insurers shall communicate the details of lapses, if any, committed by the RAPs to the other stakeholders such as service partner agency and CSC-SPV for necessary action.
The Authority may suspend or cancel the registration of CSC-SPV for any one or more of the following reasons:
(i) suffers at any time during the period of the registration from any of the disqualifications specified under sub-section (5) of section 42D of the Act;
(ii) violates the provisions of the Act, IRDA Act, 1999 and Rules, Regulations, Guidelines, Notices, Circulars made there under, such as:
(a) Fails to furnish any information relating to its insurance related activities as required by the Authority;
(b) Furnishes wrong or false information; or conceals or fails to disclose material facts in the application submitted for obtaining registration;
(c) Indulges in rebates or inducements in cash or kind to a client or any of the client's Directors or other employees or any person acting as an introducer;
(d) Fails to carry out its obligations as specified in these Regulations.
(e) Fails to comply with any of the conditions subject to which the registration has been granted.
(f) Fails to comply with duties and obligations of CSC-SPV towards RAP
(g) Fails to comply with duties and obligations of CSC-SPV towards Insurers
(iii) Resort to spurious calls or mis-selling;
(iv) Acts in a manner against the interest of the policyholders or against public interest.
1. The Authority shall issue a Show Cause Notice to the CSC-SPV, requiring them to show cause within 21 days from the date of receipt of the notice, why the registration granted to the CSC-SPV shall not be suspended or cancelled or any other action as considered appropriate by the Authority for the violations noted in the show cause notice shall not be taken.
2. The CSC-SPV shall submit its reply to show cause notice issued by the Authority within the time limit stipulated in the notice.
3. Upon considering the reply, if any, the Authority may pass an order directing the suspension or cancellation of the registration granted to the CSC-SPV or shall pass any other order as deemed appropriate based on the facts of the case.
4. The Authority shall communicate the decision to the CSC-SPV within thirty days from the date of taking such decision stating therein the grounds on which the decision is taken.
5. The CSC-SPV, aggrieved by the decision of the Authority may make an appeal to Securities Appellate Tribunal (SAT), as per the procedure prescribed for such an appeal, within a period of forty-five days from the date on which a copy of the order made under clause (4) above is received by him, for passing such orders thereon as it thinks fit, conforming, modifying or setting aside the order appealed against.
6. In case the Securities Appellate Tribunal after consideration of the application made under clause (5) above, rejects the appeal, the Applicant can make a fresh application for grant of registration only after one year from the date of final rejection. The Authority may consider such application on merit.
The Registration of CSC-SPV may be cancelled or suspended without notice, provided the Authority has communicated the reasons for the cancellation in writing:
(i) if it is found guilty of fraud, or is convicted for a criminal offence;
(ii) commits such defaults, which require immediate action in the opinion of the Authority;
The procedure to be followed while initiation of Action against the CSC-SPV under this regulation is as specified in clauses of Part II above.
(i) The Certificate of RAP may be cancelled or suspended after due notice and after giving him a reasonable opportunity of being heard, if the RAP is found guilty of misconduct or his conduct is not in accordance with the code of conduct as specified in these Regulations, or fails to carry out his obligations as specified under these Regulations.
(ii) The procedure to be followed while initiation of Action against the RAP will be as specified in Part II above as applicable to CSC-SPV.
(iii) The procedure enunciated above shall be undertaken by the CSC-SPV who shall then submit a report to the Authority for a decision.
(i) The certificate of RAP may be cancelled or suspended without notice if he is found guilty of fraud, or is convicted for a criminal offence, or commits such defaults which require immediate action in the opinion of the Authority, provided that the Authority has communicated the reasons for the cancellation in writing.
(ii) The procedure to be followed while initiation of Action against the RAP is specified in Part II above as applicable to CSC-SPV
(iii) The procedure enunciated above shall be undertaken by the CSC-SPV who shall then submit a report to the Authority for a decision.
(i) CSC-SPV, whose registration has been suspended or cancelled by the Authority, shall, on and from the date of the receipt of the communication under these Regulations, shall cease to act as an intermediary and shall cease to solicit Insurance business.
(ii) On and from the date of suspension or cancellation of the registration of the CSC-SPV, the CSC-SPV shall:
(a) not undertake any new assignment or contract related to insurance business or solicit or procure insurance business during the period of such debarment or suspension;
(b) take such other action including the action relating to any records or documents and policies or money of the policyholders as per the directions of the Authority and relevant provisions of these regulations.
(c) return the certificate of registration so cancelled to the Authority and shall not represent itself to be a holder of registration for carrying out the activity for which such registration had been granted;
(d) make provisions as regards liability incurred or assumed by it;
(e) take such other action including the action relating to recovery or seizure of any records or documents and policies of the policyholders that may be in custody or control of such person, within the time period and in the manner, as may be required under the relevant regulations or as may be directed by the Authority while passing order under this Schedule or otherwise.
(f) take action as specified in these regulations.
1. IRDA, Noti. No. F. No. IRDAI/Reg/16/106/2015, dated October 5, 2015, published in the Gazette of India, Extra., Part III, Section 4, dated 19th October, 2015, pp. 26-50, No. 348.