TaxTMI 
TaxTMI 
Code of conduct
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....t it is dealing with and the extent of the client's awareness of risk and insurance; (viii) obtain written mandate from client to represent the client to the insurer and communicate the grant of a cover to the client after effecting insurance. Unless it is specifically mentioned otherwise, the written mandate obtained from the client shall be valid for a period of one (1) year if the mandate has no validity period mentioned. However, in the case of pre-underwritten policies or retail/individual policies there is no requirement of obtaining mandate from the client; (ix) obtain written mandate from client to represent the client to the insurer/ reinsurer; and confirm cover to the insurer after effecting re-insurance, and submit relevant reinsurance acceptance and placement slips; (x) avoid conflict of interest; (xi) Obtain necessary documents required under KYC norms and share with insurance company; (xii) Assist the client in opening e-insurance account. (3) Conduct in matters relating to Sales practices- Every insurance broker shall: (i) confirm that he does not employ agents or canvassers to bring in business; (ii) ....
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....of disclosing all subsequent changes that might affect the insurance throughout the duration of the policy; (vi) 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 - Every insurance broker shall: (i) provide the list of insurer(s) participating under the insurance contract and advise any subsequent changes thereafter; (ii) 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; (iii) quote terms exactly as provided by insurer; (iv) 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; (v) provide the client with prompt written confirmation that insurance has been effected. (vi) If the final policy wording is not included with this confirmation, the same shall be forwarded as soon as possible; (vii) notify changes to the terms and conditions of any insuranc....
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....vise the member of staff who will be dealing with the complaint and the timetable for dealing with it; (iv) ensure that response letters are sent along with information about remedies available, if complainant is not satisfied with the response; (v) ensure that complaints are dealt with at a suitably senior level; (vi) have in place a system for recording and monitoring complaints. (9) Conduct in relation to documentation - Every insurance broker shall:- (i) ensure that any documents issued by it, comply with all statutory or regulatory requirements from time to time in force; (ii) send policy documentation without avoidable delay; (iii) make available, with policy documentation, advice that the documentation shall be read carefully and retained by the client; (iv) not withhold documentation from its clients without their consent, unless adequate and justifiable reasons are disclosed in writing and without delay to the client. Where documentation is withheld, the client must still receive full details of the insurance contract; (v) acknowledge receipt of all monies received in connection with an insurance po....
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..... (13) Every insurance broker 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) An insurance broker as defined in these regulations shall not act as an insurance agent of any insurer under section 42 of the Insurance Act. (15) Every insurance broker shall abide by the provisions of the Insurance Act, 1938 (4 of 1938), IFSCA Act, 2019, rules and regulations made there under which may be applicable and relevant to the activities carried on by them as insurance brokers. (16) Additional Code of Conduct for Reinsurance Broker and Composite Broker (a) The reinsurance broker/composite broker while arranging reinsurance covers to its clients shall enter into a Terms of Business Agreement (TOBA) with the (re)insurer. The TOBA shall include, amongst the other things, the following: (i) Nature and Scope; (ii) Disclosures and documentation; (iii) Premiu....
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....with the insurer/reinsurer in a manner consistent with good market practice. (h) The insurance broker shall confirm to the insurer the remittance of premium and receipt of the same by the reinsurer concerned within ten (10) days of such remittance. (i) Immediately after completion of placement of reinsurance, the insurance broker may issue an insurance broker's cover note giving the terms of cover and the names of reinsurers and the shares placed with each of them. The cover note may contain a listing of all important clauses and conditions applicable to the reinsurance and where the wordings of clauses are not market standard, the wordings to be used in the reinsurance contract shall be attached to the insurance broker's cover note. (j) The insurance broker shall follow up the cover note by a formal signed reinsurance policy document or other acceptable evidence of the reinsurance contract signed by the reinsurers concerned, within one (1) month of receipt of reinsurance premium. (k) The insurance broker shall have a security screening procedure in-house or follow credit ratings given by recognized credit rating agencies and answer without any d....
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....insurer in India or in the IFSC, a true and complete copy of the placement slip to be used, before committing any terms to the overseas insurer. The insurance broker shall incorporate any modifications or corrections proposed by the Reinsurer in the placement slip. (iv) The insurance broker shall put up to the overseas insurer, all the terms (including the reinsurance commission and brokerage allowed) obtained by it from various Indian / the IFSC reinsurers and indicate the share the reinsurer(s) is willing to write at those terms and the expectation of the insurance broker about placement of the required reinsurance at the terms quoted, with acceptable reinsurance security. (v) The insurance broker shall furnish to the overseas insurer, a true copy of the placement slip signed by the Indian / the IFSC reinsurer quoting terms, indicating thereon, the signed line of the reinsurer. (vi) Where reinsurance on a risk is proposed to be placed with different reinsurers at different terms, the fact that terms for all reinsurers are not uniform, shall be disclosed to reinsurers suitably. (vii) The insurance broker shall provide complete information as des....
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.... shall be the duty of every TPA, its Chief Administrative Officer or Chief Executive Officer or Branch Head and Chief Medical Officer and its employees or representatives to- (a) establish their identity to the insured, claimant, policyholder and that of the insurer with which it has entered into an agreement, other entities and the public; (b) disclose its certificate of registration on demand to the insured, policyholder, claimant, prospect, public or to any other entity relating to the services under a policy issued by an insurer; (c) disclose on demand to the insured, policyholder, claimant, prospect, public or to any other entity the details of the services it is authorized to render in respect of health insurance products under an agreement with an insurer; (d) bring to the notice of the insurer with whom it has an agreement any adverse report or inconsistencies or any material fact that is relevant for the insurer concerned; (e) obtain all the requisite documents pertaining to the examination of an insurance claim arising out of an insurance contract; (f) render such assistance as mentioned under the agreement and advice ....
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....hypothecation of property or on personal security or otherwise, as part of the benefits to the fulltime employees of the TPA as per the scheme duly approved by its Board of Directors; (s) refrain from submission of any wrong, incorrect, misleading data or information or undertaking to the Authority or to the insurer or to any other stake holder of the TPA business; (t) refrain from accepting any kind of incentives other than the fees agreed towards service fees or any inducement for maintaining low claims ratio; (u) refrain from outsourcing the job of servicing of those insurance policies for which he is appointed as TPA to any other registered entity including TPA or unregistered entity; (v) refrain from publishing on its website any incorrect or misleading information or display any content or matter which is not in line with these regulations; (w) ensure that no claim is concurred or disputed by a medical practitioner unless he is from the same stream of medicine relating to which the treatment was provided and claim is preferred; (x) disclose on demand, the fee received for servicing of Health Insurance policy to the policy ....
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....nce or insurance related activities that may lead to conflict of interest. PART-C: SURVEYOR AND LOSS ASSESSOR (1) Every Surveyor and Loss Assessor shall- (a) behave ethically and with integrity in the professional pursuits. Integrity implies not merely honesty but fair dealings and truthfulness; (b) strive for objectivity in professional and business judgment; (c) act impartially, when acting on instructions from an insurer in relation to a policy holder's claim under a policy issued by that insurer; (d) conduct himself with courtesy and consideration to all people with whom he comes into contact during the course of his work; (e) not accept or perform survey works in areas for which he does not hold a license; (f) not accept or perform work which he is not competent to undertake, unless he obtains some advice and assistance, as will enable him to carry out the work competently; (g) carry out his professional work with due diligence, care, skill and with proper regard to technical and professional standards expected of him; (h) keep himself updated with all developments relevant to his professional practi....
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....with utmost good faith and integrity at all times; (b) act with care and diligence; (c) ensure that the client understands his relationship with the corporate agent and on whose behalf the corporate agent is acting; (d) treat all information supplied by the prospective clients as completely confidential to themselves and to the insure(s) to which the business is being offered; (e) take appropriate steps to maintain the security of confidential documents in their possession; (f) No director of a company or a firm or the chief executive or a principal officer or a specified person shall hold similar position with another corporate agent. 2. Every Corporate Agent shall (a) be responsible for all acts of omission and commission of its principal officer and every specified person; (b) ensure that the principal officer and all specified person are properly trained, skilled and knowledgeable in the insurance products they market; (c) ensure that the principal officer and the specified person do not make to the prospect any misrepresentation on policy benefits and returns available under the policy; (d) ens....
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....l officer / specified person shall- (a) solicit or procure insurance business without holding a valid certificate of registration; (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 specified person or any insurance intermediary; (f) Offer different rates, advantages, terms and condition other than those offered by the insurer; (g) Force a policyholder to terminate the existing policy and to effect a new proposal from him within three (3) years from the date of such termination; (h) No corporate agent shall have a portfolio of insurance business from one person or one organization or one group of organization under which the premium is in excess of fifty precent of total premium procured in any year; (i) become or remain a director of any insurance company, except with the prior approval of the Authority; (j) indulge....