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  • Addendum to Section 5 Records Which the Company Shall be Obligated to Organize and Maintain as well as the Data and Documents that Shall be Made Available to the Authority

    • Addendum

      1. The Company shall maintain the following as a minimum for Policy Issuance, Underwriting and Policy Servicing records:
         
        1. a. Insurance application and proposal;
           
        2. b. Insurance policy;
           
        3. c. Agreement on any terms of reinsurance cover;
           
        4. d. Reinsurance contracts;
           
        5. e. The insured and beneficiary's proof of identification;
           
        6. f. Underwriting policy and procedures;
           
        7. g. The technical basis of the insurance policies and premium ratios;
           
        8. h. List of insured personnel for group policies;
           
        9. h. Medical declaration for Insurance of Persons;
           
        10. i. Policyholders register;
           
        11. j. Re-insurance registers for assumptions and cessions showing details of underwriting information by treaty, subscriptions, losses, commissions, etc., balances due to/from re-insurance companies, and supporting source documents; and
           
        12. k. Customer Complaints register.
            
      2. The Company shall maintain claim records pertaining to policyholders' claims and classify them into paid, unpaid, and rejected claims. Each record shall include the following:
         
        1. Insurance application and proposal, if available;
           
        2. Copy of the insurance policy and procedures;
           
        3. Claims policy and procedures;
           
        4. Policyholder's claim information;
           
        5. Claims register;
           
        6. Adjusters and assessor's report and any other documents pertaining to the claim and the direct reason leading to the covered loss;
           
        7. Proportional share of any other insurance and re-insurance policies in effect;
           
        8. Action taken by the Company and the status of the claim;
           
        9. A power-of-attorney from the insured to the Company to subrogate it in the following cases;
           
          1. Third party liability for the loss; and
             
          2. Defending the insured in disputed liability or in determining the indemnity amount.
              
        10. Signed settlement agreement by a person for a paid claim except in the cases of electronic medical claims where the signed settlement agreement is waived.
            
      3. The Company shall maintain the following records in relation to the calculations of Technical Provisions:
         
        1. The methods and assumptions used in establishing the Company's reserves, including the margins for adverse deviation, and the reasons for their use;
           
        2. The nature of, reasons for, and effect of, any change in approach, including the amount by which the change in approach increases or decreases its reserves;
           
        3. Stress testing and scenario analysis prepared as required;
           
        4. Reserve calculations performed for each period; and
           
        5. Claims developments within the preceding five (5) years to show the variances in building the technical provisions.
            
      4. The Company shall maintain records related to investment operations such as investment statements, summary of investment income, details of derivatives and pledged assets, supporting documentation including securities registers (including information regarding securities held by the Company outside the UAE).
         
      5. In support of the investment operations, the Company shall maintain the following records:
         
        1. Working papers, with properly referenced audit trails, to support the financial statements/ regulatory data required to be submitted to the Authority;
           
        2. Bank statements, cheque registers, monthly banks reconciliations, vouchers and receipts pertaining to the operations in the UAE, and adequate documentation to confirm that amounts due in respect of the insurance business of the Company flow to the bank accounts in the UAE;
           
        3. Records supporting amounts due to or from the head office and affiliated entities (if any);
           
        4. Policy movement reports and reserve amounts;
           
        5. Premium registers detailing premiums written, earned, and unearned;
           
        6. Listing of policy loans amounts on deposit by policy, related income or expense, and originals or copies of policy loan applications;
           
        7. A description of the accounting system;
           
        8. All agreements, including outsourcing agreements with third party and affiliates;
           
        9. All signed contracts, which are material to the Company, that relate to the administrative operation of the Company;
           
        10. Policies and practices governing the Company's operations in the UAE;
           
        11. Risk management policies and procedures;
           
        12. Details of Board of Directors minutes and other committee minutes;
           
        13. Details of any current litigation matters; and
           
        14. Actuarial reports, including valuation reports, external review reports, experience studies, etc., and supporting documentation.