The Executive Committee referred in sub-section (1) of Section 19 of the Act may in the interests of the Corporation, for reasons to be recorded in its resolution, relax any of the provisions of these regulations in individual cases.
FIRST SCHEDULE
[See Regulation 3(1)(g),(h)]
| Regulation No. |
Nature of functions |
Competent authority |
| (1) |
(2) |
(3) |
| 3(e) and 4 |
Appointment of agents |
Officer in-charge of the Branch. |
| 4(6) |
Change of agency year |
Officer in charge of the Division. |
| 8(1)(g) |
Allotment of orphan policies to agents |
Allotment Committee of the Branch. |
| 10(1) |
Commission to agents |
Chairman. |
| 13(2) |
Reinstatement of agency when failure to bring the business required of the agent was due to reasons beyond control |
Designated official of the Corporation designated as such by the Executive Director. |
| 14 |
Resignation or surrender of appointment by an agent |
Officer in-charge of the Branch. |
| 15(1) and 15(3) |
Termination of agency on account of certain disqualification |
Officer in charge of the Division. |
| 16 |
Action against agent for certain lapses and issue of direction not to solicit or procure new life insurance business |
Officer in charge of the Division. |
| 17 |
Termination of agency by notice |
Zonal Managers in charge of the Zone. |
| 18 |
Direction not to solicit or procure new life insurance business or termination of agency in insolvency cases. |
Officer in charge of the Division. |
| 19(1) |
Payment of commission on discontinuance of agency |
Officer in charge of the Division. |
| 19(6) |
Commutation of renewal commission |
Officer in charge of the Division. |
| Schedule I Reg. 21 |
Withholding of appeals Nature of functions to issue show cause notice and final order |
Officer-in-charge of the Division. |
[See Regulations 8(3), 12(1)]
Code of Conduct
(1) Every insurance agent shall
(a) identify himself as an insurance agent of the Corporation;
(b) show the agency identity card to the prospect, and also disclose the agency appointment letter to the prospect on demand;
(c) disseminate the requisite information in respect of insurance products offered for sale by the Corporation and take into account the needs of the prospect while recommending a specific insurance plan;
(d) disclose the scales of commission in respect of the insurance product offered for sale, if asked by the prospect;
(e) indicate the premium to be charged by the Corporation for the insurance product offered for sale;
(f) explain to the prospect the nature of information required in the proposal form by the Corporation, and also the importance of disclosure of material information in an insurance contract;
(g) bring to the notice of the Corporation every fact about the prospect relevant to the insurance underwriting, including any adverse habits or income inconsistency of the prospect, within the knowledge of the agent, in the form of a report called Insurance Agent's Confidential Report along with every proposal submitted to the Corporation, and any material fact that may adversely affect the underwriting decision of the Corporation as regards acceptance of the proposal, by making all reasonable enquiries about the prospect;
(h) obtain the requisite documents at the time of submitting the proposal papers to the Corporation, and other documents subsequently called for by the Corporation for completion of the proposal.
(i) advise every prospect to effect nomination under the policy;
(j) inform promptly the prospect about the acceptance or rejection of the proposal by the Corporation;
(k) render necessary assistance and advice to every policyholders on all policy servicing matters including assignment of policy, change of address or exercise of options under the policy or any other policy service, wherever necessary;
(l) render necessary assistance to the policyholders or claimants or beneficiaries in complying with the requirements for settlement of claims by the Corporation.
(2) The Insurance Agent shall not
(a) solicit or procure insurance business without being appointed to act as such by the Corporation;
(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 Corporation for acceptance of the proposal;
(d) resort to multilevel marketing for soliciting and procuring insurance policies and/or induct any prospect or policyholder to join a multilevel marketing scheme;
(e) behave in a discourteous manner with the prospect;
(f) interfere with any proposal introduced by any other insurance agent of the Corporation;
(g) offer different rates, advantages, terms and conditions other than those offered by the Corporation;
(h) demand or receive a share of proceeds from the beneficiary under an insurance contract;
(i) force a policyholder to terminate the existing policy and to effect a new policy from him within three years from the date of such termination of the earlier policy;
(j) apply for fresh agency appointment to act as an insurance agent, if his agency appointment was earlier cancelled by the designated official, and a period of five years has not elapsed from the date of such cancellation;
(k) become or remain a director of any insurer.
(3) Every agent shall, with a view to conserving 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 notice to the policyholder orally and in writing.
(4) Any person who acts as an insurance agent in contravention of the provisions of the IRDAI Act shall be liable to penalty and disciplinary action by the Corporation.
[See Regulation 10(2)]
Bonus commission payable to agents
1. In this Schedule, eligible first year commission means the first year commission earned by an agent in any agency year excluding the commission earned under single premium policies, deferred annuity policies and pure endowment policies secured by him.
2. An agent including an absorbed agent shall be entitled to bonus commission at the rate of forty per cent of the eligible first year commission if he has secured not less than six proposals on different lives resulting in a completed business and a first year premium income of at least fifty thousand rupees in the respective agency year.
3. Where an agent has earned bonus commission for five successive years in accordance with the foregoing provision of this Schedule, he shall be entitled to bonus commission for the agency year immediately following such five years even if he has not fulfilled in respect of that year the conditions set out in the said provision.
4. Notwithstanding anything contained in the Paragraphs 2 and 3, an agent who has been exempted under sub-regulation (2) of Regulation 9, shall be entitled to bonus commission, if he has to his credit at the time of such exemption fifteen qualifying years as defined in the Fourth Schedule.
[See Regulation 11]
Gratuity and Term Insurance
1. In this Schedule unless the context otherwise requires,
(a) Agency year in the case of an absorbed agent, includes every period of twelve months prior to the first agency year, but in the case of only agent does not include an agency year during which the agent has worked for less than twelve complete months;
(b) eligible rate means:
(i) in the case of an agent who has worked on the relevant date for fifteen agency years or more as an agent, 180th part of the aggregate of the qualifying yearly renewal commission earned by him in the qualifying years out of the fifteen agency years immediately preceding the relevant date; and
(ii) in the case of an agent who has worked on the relevant date for less than fifteen agency years as an agent, one twelfth of the amount arrived at by dividing the aggregate of the qualifying yearly renewal commission earned by him in the qualifying years by the total number of agency years he has worked as an agent on the relevant date.
(c) qualifying year means:
(i) the agency year in which an agent, acting on behalf of the corporation between the 1st September, 1956, and the published day, had completed a business of not less than the previous guarantee; or
(ii) the agency year in which an agent, functioning or continuing to function after the published day, had completed the business required of him under the Regulation 9, but in respect of an absorbed agent the first agency year shall not be a qualifying year unless he had completed a business of not less than the modified previous guarantee;
(d) qualifying yearly renewal commission means
(i) in respect of agency years ending on or after the 1st April, 1968, the renewal commission earned by an agent in a qualifying year included in such agency years; and
(ii) in respect of agency years ending on or before the 31st March, 1968 one third of the aggregate of the renewal commission earned in the three agency years immediately preceding the 1st April, 1971;
(e) relevant date means the date on which the eligibility for payment of gratuity is determined under Paragraph 2.
2. (1) An agent shall be eligible for gratuity:
(i) if he has worked continually and for fifteen or more qualifying years, and
(a) he is not below sixty years of age; or
(b) his agency ceases or stands terminated under any of the provisions of these regulations for any reason other than an expected reason; or
(ii) if he has been confirmed in his appointment, an
(a) he dies while his agency is subsisting; or
(b) his appointment as agent is terminated under clause (m) of sub-regulation (1) of Regulation 16.
Explanation. In this sub-paragraph, expected reason means any of the reasons mentioned in
(i) clause (c) or clause (d) of Regulation 15;
(ii) clause (b) or clause (c) or clause (h) or clause (k) of sub-regulation (1) of Regulation 16; or
(iii) clause (1) of sub-regulation (1) of Regulation 16, if it is established that the agent had acted with a view to defrauding the Corporation.
(2) An agent may, before he has attained the age fifty-nine years, by notice in writing to the designated official, request that his eligibility for gratuity may be determined on completion of sixty-five years of age, and in that case sub-clause (a) of clause (2) of sub-paragraph (1) shall have effect as if for the word sixty the word sixty-five had been substituted, and the relevant date shall be computed accordingly.
(3) Gratuity admissible to an agent shall be at the eligible rate for each qualifying year for the first fifteen qualifying years and at half the eligible rate for the subsequent ten qualifying years, provided the maximum amount of gratuity payable shall not exceed three lakh rupees.
(4) Subject to any lien the Corporation may have on the amount of gratuity admissible to an agent, it shall pay the agent or his nominee or, if no nomination is made or is subsisting, his heirs, the amount of gratuity admissible under the paragraph.
(5) Notwithstanding anything contained in the foregoing sub-paragraph, no gratuity shall be admissible to an agent who is also an employee of the Corporation for the period he remains such employee and his agency work in such period shall not count for any purpose under this clause even after the cessation of his service as an employee.
(6) Where an agent has received any gratuity under this paragraph, no further gratuity shall be admissible to him for any period during which he works thereafter as an agent.
3. (1) In the event of the death of an agent while his agency subsists, the Corporation shall make payment of an amount in accordance with the provisions hereinafter contained if the following conditions are satisfied in respect of such agent
(a) he had not completed fifty years of age on the date of his appointment as an agent.
Explanation. For determining the date of appointment of an absorbed agent, the actual date of his appointment before the published day as an insurance agent shall be taken into account;
(b) his death takes place before he has completed sixty years of age;
(c) he had an insurance policy (other than a temporary insurance policy) on his own life assuring a sum of not less than five thousand rupees which was in force at the time of his death:
Provided that in the case of an absorbed agent, this condition shall be deemed to have been satisfied if he has held a policy which matured for payment at any time after he has completed fifty-five years of age; and
(d) he, not an being absorbed agent, has been confirmed as an agent and has to his credit three or more qualifying years at the date of his death, or he, being an absorbed agent, has to his credit three qualifying years and has either
(i) completed five agency years at the date of his death; or
(ii) undergone such training and passed such tests, as prescribed under Regulation 6.
(2) The amount payable under sub-paragraph (1) (hereinafter referred to as the amount of term insurance) shall be base on the average annual renewal commission earned by the agent in the three agency years immediately preceding his death (hereinafter referred to as the average commission) and shall be according to the following scale, namely
| |
Average Commission |
Amount of term insurance |
| (1) |
(2) |
(3) |
| (a) |
If the average commission was less than Rs. 1,001 |
Rs. 3000. |
| (b) |
If the average commission was Rs. 1001 or more, but less than Rs. 15,000 |
Rs. 3000 plus one half of the excess of average commission over Rs. 1000. |
| (c) |
If the average commission was Rs. 15000 or more |
Rs. 10000. |
(3) Subject to any lien the Corporation may have on the amount of term insurance admissible in the case of an agent, it shall pay his nominee or nominees, or if no nomination is made or is subsisting, his heirs the amount of term insurance admissible under this paragraph.
(4) Notwithstanding anything contained in the foregoing sub-paragraph, the amount of term insurance shall not be admissible in respect of an agent who was also an employee of the Corporation if his death had taken place during the period he remained such employee and his work as agent during such period shall not count for any purpose even after the cessation of his service as an employee.
[See Regulations 15(2) and (3), 16(1) and(2)]
Disciplinary Action
1. Manner of holding enquiry before or after suspension of appointment of agent.
(1) The appointment of an agent shall not be cancelled unless an enquiry has been conducted in accordance with the procedure laid down in this Schedule.
(2) For the purpose of holding an enquiry or investigation, the competent authority may appoint an officer as an Enquiry Officer for the irregularities enumerated under Regulation 16 within fifteen days of issuance of suspension order, wherever issued, to conduct the enquiry or investigation.
(3) The Enquiry Officer may direct the agent concerned to furnish all information/data as deemed necessary to conduct the enquiry and grant the agent a time of twenty-one days from the receipt of letter or date of receipt of the suspension order, for submission of his reply and such information or data called for.
(4) The agent may, within twenty-one days from the date of receipt of such notice, furnish to the Enquiry Officer a reply together with copies of documentary or other evidence relied on by him or sought by the Enquiry Officer.
(5) The Enquiry Officer shall give a reasonable opportunity of hearing to the agent to enable him to make submissions in support of his reply.
(6) The agent may either appear in person or through any person duly authorized by him to present his case, provided however that the prior approval of the competent authority is obtained for the appearance of the authorised person.
(7) The Enquiry Officer may advise the competent authority to present its case through one of its officials.
(8) If it is considered necessary, the Enquiry Officer may call for feedback or information from any other related entity during the course of enquiry.
(9) If it is considered necessary, the Enquiry Officer may call for additional papers from the agent.
(10) The Enquiry Officer shall make all necessary efforts to complete the enquiry or investigation within forty five days of the commencement of the enquiry.
(11) In case the enquiry cannot be completed within the period of forty-five days, the Enquiry Officer may seek additional time from the competent authority stating the reason thereof.
(12) The Enquiry Officer shall, after taking into account all relevant facts and submissions made by the agent, furnish a report making his/her recommendations to the competent authority.
(13) The competent authority shall issue a show cause notice directing the agent to submit his say within fifteen days from the date of receipt of the show cause notice proposing termination, and shall pass a final order in writing with such decision as he deems fit and communicate to the concerned agent.
(14) On issuance of the final order for termination of agency of the agent, he shall cease to act as an agent from the date of the final order.
2. Publication of order of suspension or termination. (1) The order of suspension or termination of appointment of the insurance agent under Regulation 15 or Regulation 16 shall be displayed on website of the Corporation and updated in centralised list of agents maintained by the authority, so that registration of new business by the suspended or terminated agent is stopped forthwith by the Corporation.
(2) On and from the date of suspension or termination of agency appointment, the agent, shall cease to function as an agent of the Corporation.
3. Effect of suspension or termination of agency appointment. (1) On and from the date of suspension or termination of the agency, the agent shall cease to act as an agent.
(2) The competent authority shall recover the appointment letter and identity card from the agent whose appointment has been terminated within seven days of issuance of final order effecting termination of appointment.
(3) The competent authority shall black-list the agent and enter the details of the agent whose appointment is suspended or cancelled into the blacklisted agent's database maintained by the authority and the centralised list of agents' database maintained by the competent authority in online mode, immediately after issuance of the order effecting suspension or termination.
(4) In case a suspension is revoked in respect of any agent on conclusion of disciplinary action by way of issuance of a speaking order by the competent authority, the details of such agent shall be removed from list of blacklisted agents as soon as the speaking order revoking his suspension is issued.
(5) The competent authority, may inform other insurers, with whom he is acting as an agent, of the action taken against the agent for their records and necessary action.