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APPLICATION FORM: USING A METHOD WHICH IS DIFFERENT TO THE METHOD PRESCRIBED IN DETERMINING THE AMOUNT OF THE UNEARNED PREMIUM PROVISION OF A SHORT-TERM INSURER
Instructions:
1. This application form must be completed in accordance with the Information relating to an application for using a method which is different to the method prescribed in determining the amount of the unearned premium provision of a short-term insurer-document included at the end of this application form.
2. An application form that does not comply with the instructions and guidance provided in the Information relating to an application for using a method which is different to the method prescribed in determining the amount of the unearned premium provision of a short-term insurer-document will not be considered.
3. All questions must be answered or marked not applicable (N/A).
4. All supporting documentation attached in addition to that referred under paragraph D of the Information relating to an application for using a method which is different to the method prescribed in determining the amount of the unearned premium provision of a short-term insurer-document (i.e. documents that must accompany this application) must also be indicated in Part 6 of this form.
5. The application must be accompanied by proof that the prescribed fee has been paid.
Insurer Name
1.1 Physical business address
1.2 Postal Code
1.3 Postal business address
1.4 Postal Code
2.1 Is the insurer in run-off (i.e. no longer taking on new insurance business)?
YES NO
2.2 If the answer to 2.1 is yes, provide the reason for the insurer being in run-off
2.3 If the answer to 2.1 is yes, provide the date
from which the insurer has been in run off. Also attach
the relevant resolution of the board of directors.
2.4 Are any of the insurer’s liabilities re-insured?
YES NO
2.5 If the answer to 2.4 is yes –
2.5.1 provide the percentage (%) of liabilities that
are reinsured under approved reinsurance
policies.
2.5.2 provide the percentage (%) of liabilities that
are reinsured under reinsurance
that are not approved reinsurance policies.
2.5.3 indicate the type of reinsurance.
2.6 Is the insurer financially unsound in terms of -
2.6.1 section 29(1) of the Short-term Insurance Act?
YES NO
2.6.2 section 29(2) of the Short-term Insurance Act?
YES NO
2.6.3 section 30(1) of the Short-term Insurance Act?
YES NO
2.7 If the answer to 2.6.1 is yes, state the shortfall
in Rands.
2.8 If the answer to 2.6.2 is yes, state the shortfall
in Rands.
2.9 If the answer to 2.6.3 is yes, state the shortfall
in Rands.
Is the insurer applying to -
3.1 use a method which is different to the method in determining the amount of the unearned premium provision (“UPP”) prescribed in paragraph 4.1.1 of Board Notice 169 of 2011?
YES NO
3.2 If the answer to 3.1 is yes, provide the proposed method.
3.3 use a method which is different to the method in determining the amount of the UPP prescribed in paragraph 4.1.2 of Board Notice 169 of 2011?
YES NO
3.4 If the answer to 3.3 is yes, provide the proposed method.
3.5 Indicate the period for which the method in 3.2 and/or 3.4 will be required.
3.1 In respect of what is the relaxation of the capital adequacy requirement applied for?
4.1 Motivate why the method which is different from the prescribed method in determining the amount of the UPP is required, and attach supporting information.
4.2 Explain the methodology that is proposed.
4.3 Provide the amount of the UPP calculated on the prescribed method versus that calculated on the method described in 3.2 and/or 3.4 read with 4.2.
UPP calculated on prescribed method (R’000)Date: --/--/20--
/ UPP calculated on proposed method (R’000)Date: --/--/20--
4.4 Indicate the class(es) of policies to which the method in 3.2 and/or 3.4 read with 4.2 will apply.
4.5 Submit copies of the statement showing surplus assets in the most recent statutory return should approval -
4.5.1 be granted; and
4.5.2 not be granted.
The statements must be completed in conjunction with the auditor(s). The statements shall be submitted both as hard copy and in Excel format. These statements must correspond with the information contained in the actuarial report.
5.1 Did the insurer inform its auditor of this application?
YES NO
5.2 If the answer to 5.1 is no, provide reasons.
5.3. Are there any matters that might endanger the maintenance of the insurer’s financially sound condition as envisaged in section 28 of the Short-term Insurance Act?
YES NO
5.4 If the answer to 5.3 is yes, provide reasons.
5.5 Are there any other information or documentation that are relevant to this application?
YES NO
5.6 If the answer to 5.5 is yes, list the information or documents in Part 6.
Clearly indicate the attachments that have been included with this application form.
Description / Number of pagesAttachment A / Sufficient evidence and justification to demonstrate that the method is appropriate and adequate.
Attachment B / An actuarial report signed off by an actuary holding a relevant and valid practising certificate issued by the Actuarial Society of South Africa.
Attachment C / Copies of the statements showing surplus assets in the most recent statutory return, should approval be granted and not granted.
Attachment D / Proof that the prescribed fee has been paid.
Attachment E
Attachment F
Attachment G
Attachment H
Attachment I
Explanatory Note:
Details of the public officer must be provided. The Registrar will liaise with the public officer and all correspondence from the Registrar will be sent to the public officer.
7.1 Full name and surname
7.2 Telephone / cellular phone number
7.3 Fax number
7.4 E-mail address
The insurer hereby authorises the Financial Services Board, and its duly authorised agent, to request or confirm any information provided in support of this application with any person.
The insurer authorises such other person/s to furnish information regarding this application to the Financial Services Board and its duly authorised agent. The insurer unconditionally indemnifies the Financial Services Board, its agent and any person/s against any liability that may result from furnishing information in this regard.
I, ………………………………………………………………………………………………..[Insert full name of public officer], identity / passport number ……………………………………………………. hereby certify, to the best of my knowledge, that the information provided in the application form and any attached information are complete, accurate, true and not misleading in any respect.
…………………………….……….. ………………………...
Signature of public officer Date
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INFORMATION RELATING TO AN APPLICATION FOR USING A METHOD WHICH IS DIFFERENT TO THE METHOD PRESCRIBED IN DETERMINING THE AMOUNT OF THE UNEARNED PREMIUM PROVISION OF A SHORT-TERM INSURER
A. Introduction
1. This application form relates to an application for approval by the Registrar, for the use of a method which is different to the method prescribed in determining the amount of the unearned premium provision in section 32(1)(b) of the Short-term Insurance Act of a short-term insurer.
2. The amount referred to in section 32(1)(b) of the Short-term Insurance Act shall be the amount calculated by means of the method set out in paragraph 4.1.1 or 4.1.2 of Board Notice 169 of 2011, or such other method as the Registrar may direct in a particular case. Board Notice 169 of 2011 is issued under item 2 of Part I of Schedule 2 of the Short-term Insurance Act. Board Notice 169 of 2011 on the Prescribed requirements for the calculation of the value of assets, liabilities and capital adequacy requirement of short-term insurers published in Gazette 34715 of 28 October 2011 came into effect on 1 January 2012.
3. In terms of paragraph 4.1.3(a) of the Board Notice 169 of 2011 an insurer may apply for approval to use a method which is different to the prescribed method in determining the amount of the unearned premium provision in section 32(1)(b) of the Short-term Insurance Act. The application must set out all the reasons for, and information relevant to, the application.
4. The method that is applied for must be based on sound actuarial and financial principles. The method must be supported by sufficient evidence and justification to demonstrate that it is appropriate and adequate. Included in the supporting evidence must be an actuarial report signed off by an actuary holding a relevant and valid practising certificate issued by the Actuarial Society of South Africa.
5. The Registrar, if satisfied that another method other than that set out in paragraph 4.1.1 or 4.1.2 of Board Notice 169 of 2011 will place a more appropriate value on the liabilities; concerned, may under paragraph 4.1.3(a) on application by an insurer, approve the use of another method.
6. A short-term insurer that wishes to apply to use a method which is different to the prescribed method in determining the amount of the unearned premium provision must complete this application form and submit the supporting documentation called for in this application form.
B. Interpretation
In this form any word or expression defined in the Short-term Insurance Act or Board Notice 169 of 2011, as the case may be, including any measure referred to in the definitions of the Short-term Insurance Act in sections 1(1) of the Short-term Insurance Act have, unless the context otherwise indicates, the meaning so defined.
Note that, if there is any discrepancy between this application form and the provisions of the Short-term Insurance Act, the provisions in the Short-term Insurance Act will be deemed correct.
C. Instructions
1. Applications must be submitted directly to the Financial Services Board.
2. This application form must be completed in full by the responsible person and be signed by the public officer or the person duly authorised to sign this form. If a person other than the public officer of the insurer signs the form, proof of the authorisation must be attached to this application form.
3. This application form must be completed with reference to the instructions and explanatory notes. The format of the form or the wording of questions may not be changed.
4. The application must be accompanied by the documents referred to in paragraph D below.
5. The application must be accompanied by proof that the prescribed fee has been paid.
6. Application forms that do not comply with 1 – 5 above, will not be processed and will be returned to the applicant.
D. Documents that must accompany this application
The application must be accompanied by the following documents and listed in Part 6 of the application form:
1. Sufficient evidence and justification to demonstrate that the method it is appropriate and adequate.
2. An actuarial report signed off by an actuary holding a relevant and valid practising certificate issued by the Actuarial Society of South Africa
3. Copies of the statement showing surplus assets in the most recent statutory return, should approval be granted and not granted.
4. Proof that the prescribed fee has been paid.
E. Additional Information
The Registrar, in accordance with section 4(2) of the Short-term Insurance Act may request additional information relating to this application.