~-Boito ~-33004/99 REGI} NO. D.L.

-33004/99

~<I!lt.t

Of)1'
Q:he <!JoLette of ~ndia ~
EXTRAORDINARY
"fl1Tm-~4
PART ill-Section 4
5Ilftt"fii< ~ 5I..,lfllo
PUBLffiHEDBYAUTHORITY

~. 147] "Ii ~, ,eflifilQI(, ~ 10, 200Sf'.iIi1fficIi 19, 1927

No. 147] NEW DELHI, THURSDAY, NOVEMBER 10, 20051KARTIKA 19, 1927

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3248 GI/200S (I)
 THE GAZETfE OF INDIA: EXTRAORDINARY [PART III-SEc. 4]
2

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 3

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4 TIlE GAZETIE OF INDIA : EXTRAORDINARY [PART III-SEC. 41

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6. TIIE GAZETTE OF INDIA: EXTRAORDINARY [pARrIll-SEC. 4]

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[~IUIIVI1611200S/3ffiT. ]
 THE GAZETTE OF INDIA: EXTRAORDINARY [PART III-SEc. 4]
8

INSURANCE REGULUORY AND DEVELOPMENT AUTHORITY

NOTIFICATION
Hyderabad, the lOth November, 2005

Insurance Regulatory and Development Authority (Micro-Insurance) Regulations, 2005

F. No. IRDAIMI/3/200S:-In exercise of the powers conferred by Section 114A of the

Insurance Act, 1938 (4 of 1938) read with Section 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>

Short title and commencement.- (1) These regulations may be called the Insurance
Regulatory and Development Authority (Micro-insurance) Regulations, 2005.

(2) They shall come into force from the date of their publication in the Official Gazette.

2. Definitions.- In these regulations, unless the context requires otherwise-

(a) "Act" means the Insurance Act, 1938 (4 of 1938);

(b) "Authority" means the Insurance Regulatory and Development Authority

established under sub-section (1) of section 3 of the Insurance Regulatory and
Development Authority Act, 1999 (41 of 1999);

(c) "family" means a unit comprising of husband, wife, dependant parents and a
maximum of three children.

Provided that where the number of children is more than three, for construing the
composition of family as aforesaid, the first three children shall be included.

Provided further that an insurer may, within the aforesaid parameters laid down
for the composition of the family, define 'family' as per the requirements of the
individual or group.

(d) "general micro-insurance product" means any health insurance contract, any
contract covering the belongings, such as, hut, livestock or tools or instruments or
any personal accident contract, either on individual or group basis, as per terms
stated in Schedule-I appended to these regulations;
 9

(e) "life micro-insurance product" means any term insurance contract with or without
return of premium, any endowment insurance contract or health insurance
contract, with or without an accident benefit rider, either on individual or group
basis, as per terms stated in Schedule-II appended to these regulations;

(f) "micro-insurance agent" means.- (i) a Non-Government Organisation (NGO); or

(ii) a Self Help Group (SHG); or (iii) a Micro-Finance Institution (MFI), who is
appointed by an insurer to act as a micro-insurance agent for distribution of
micro-insurance products.

Explanations- For the purposes of these regulations.-

(I) Non-Government Organisation (NGO) means a non-profit organization

registered as a society under any law, and has been working at least for three
years with marginalized groups, with proven track record, clearly stated aims and
.,
objectives, transparency, and accountability as outlined in its memorandum,
rules, by-laws or regulations, as the case may be, and demonstrates involvement
of committed people.

(II) Self Help Group (SHG) means any informal group consisting of ten to twenty
or more persons and has been working at least for three years with marginalized
groups, with proven track record, clearly stated aims and objectives, transparency,
and accountability as outlined in its memorandum, rules, by-laws or regulations,
as the case may be, and demonstrates involvement of committed people.

(III) Micro-Finance Institution means any institution or entity or association

registered under any law for the registration of societies or co-operative societies,
as the case may be, inter alia, for sanctioning loan/finance to its members.

(g) "micro-insurance policy" means an insurance policy sold under a plan which has
been specifically approved by the Authority as a micro-insurance product;

(h) "micro-insurance product" includes a general micro-insurance product or life

insurance product, proposal form and all marketing materials in respect thereof;

(i) all words and expressions used herein and not defined but defined in the
Insurance Act, 1938 (4 of 1938), or in the Insurance Regulatory and Development
Authority Act, 1999 (41 of 1999) or in any Rules or Regulations made there under
shall have the meanings respectively assigned to them in those Acts or Rules or
Regulations.

3. Tie-up between life insurer and non-life insurer.- (1) An insurer carrying on life
insurance business may offer life micro-insurance products as also general micro-
insurance products, as provided herein.

Provided that where an insurer carrying on life insurance business offers any general
micro-insurance product, he shall have a tie-up with an insurer carrying on general
insurance business for this purpose, and subj ect to the provisions of section 64VB of the
Act, the premium attributable to the general micro insurance product may be collected
from the prospect (proposer) by the insurer carrying on life insurance business, either
directly or through any of the distributing entities of micro-insurance products as
'3~43 C;I-(().<;:~~
10 THE GAZETTE OF INDIA: EXTRAORDINARY [PART Ill-SEC. 4]

specified in regulation 4, and made over to the insurer carrying on general insurance
business.

Provided further that in the event of any claim in regard to general micro-insurance
products, the insurer carrying on life insurance business or the distributing entities of
micro-insurance products, as the case may be, as may be specified in the tie-up referred
to in the first proviso, shall forward the claim to the insurer carrying on general insurance
business and offer all assistance for the expeditious disposal of the claim.

(2) An insurer carrying on general insurance business may offer general micro-insurance
products as also life micro-insurance products, as provided herein.

Provided that where an insurer carrying on general insurance business offers any life
micro-insurance product, he shall have a tie-up with an insurer carrying on life insurance
business for this purpose, and subject to the provisions of section 64VB of the Act, the
premium attributable to the life micro insurance product may be collected from the
prospect (proposer) by the insurer carrying on general insurance business, either directly
or through any of the distributing entities of micro-insurance products as specified in
regulation 4, and made over to the insurer carrying on life insurance business.

Provided further that in the event of any claim in regard to life micro-insurance products,
the insurer carrying on general insurance business or the distributing entities of micro-
insurance products, as the case may be, as may be specified in the tie-up referred to in the
first proviso, shall forward the claim to the insurer carrying on life insurance business and
offer all assistance for the expeditious disposal of the claim. '

4. Distribution of micro-insurance products.- In addition to an insurance agent or

corporate agent or broker licensed under the Act, read with the regulations concerned
made by the Authority for licensing of individual or corporate agents, or insurance
brokers, as the case may be, micro-insurance products may be distributed through the
micro-insurance agents.

Provided that a micro-insurance agent shall not distribute any product other than a micro
-insurance product.

5. Appointment of micro-insurance agents.- (1) A micro-insurance agent shall be

appointed by an insurer by entering into a deed of agreement, which shall clearly specify
the terms and conditions of such appointment, including the duties and responsibilities of
both the micro-insurance agent and the insurer.

Provided that before entering into every such agreement, the same shall be got approved
. by the head office of the insurer.

(2) A micro-insurance agent shall not work for more than one insurer carrying on life
insurance business and one insurer carrying on general insurance business.

(3) The deed of agreement referred to in sub-regulation (1) shall specifically authorize the
micro-insurance agent to perform one or more of the following additional functions,
namely:
 11
['WTIll ~4]

a) collection of proposal forms;

b) collection of self declaration from the proposer that he/sheis in good
health;
c) collection and remittance of premium;
d) distribution of policy documents;
e) maintenance of register of all those insured and their dependants covered
under the micro-insurance scheme, together with details of name, sex, age,
address, nominees and thumb impression! signature of the policyholder;
f) assistance in the settlement of claims;
g) ensuring nomination to be made by the insured;
h) any policy administration service.

(4) The micro-insurance agent or the insurer shall have the option to terminate the
agreement referred to in sub-regulation (1), after giving a notice of three months by the
party intending to terminate the agreement.

Provided that no such notice shall be necessary, where thetermination is on account of

any misconduct or indiscipline or fraud committed by the micro-insurance agent.

6. Employment of specified persons by micro-insurance agents.- A micro-insurance

agent shall employ specified persons with the prior approval of the insurer for the
purpose of discharging all or any of the functions stated in sub-regulation (3) of
regulation 5.

Provided that corporate agents and insurance brokers procuring micro-insurance business
shall continue to be governed by the Insurance Regulatory and Development Authority
(Licencing of Corporate Agents) Regulations, 2002, and Insurance Regulatory and
Development Authority (Insurance Brokers) Regulations, 2002, as the case may be.

7. Code of conduct of Micro insurance agents.- (1) Every micro-insurance agent and
specified person employed by him shall abide by the code of conduct as laid down in
Regulation 8 of the Insurance Regulatory and Development Authority (Licensing of
Insurance Agents) Regulations, 2000, and the relevant provisions of Insurance
Regulatory and Development Authority (Insurance Advertisements and Disclosure)
Regulations, 2000.

Provided that the insurer shall ensure compliance of the code of conduct, advertisements
and disclosure norms by every micro-insurance agent.

(2) Any violation by a micro-insurance agent of the code of conduct andlor advertisement
or disclosure norms as aforesaid shall lead to termination of his appointment, in addition
to penal consequences for breach of code of conduct andlor advertisement or disclosure
norms pursuant to the provisions of sub-regulation (1).

8. Filing of micro-insurance product design.- (1) Every insurer shall be subject to the
"file and use" procedure with respect to filing of micro-insurance products with the
Authority.
12 TIlE GAZETfE OF INDIA: EXTRAORDINARY [PART III-SEC. 4]

(2) Every micro-insurance product which is cleared by the Authority for the purpose of
micro insurance shall prominently carry the caption "Micro Insurance Product".

9. Issuance of micro-insurance policy contracts- (1) Every insurer shall issue

insurance contracts to the individual micro-insurance policyholders in the vernacular
language which is simple and easily understood by the policyholders.

Provided that where issuance of policy contracts in the vernacular language is not
possible, the insurer shall as far as possible issue a detailed write-up about the policy
details in the vernacular language.

(2) Every insurer shall issue insurance contracts to the group micro-insurance
policyholder in an unalterable form along with a schedule showing the details of
individuals covered under the group, and also issue a separate certificate, to each such
individual evidencing proof of insurance, containing details of validity period of cover,
name of the nominee, and addresses of the underwriting office and the servicing office,
where both offices are not the same.

10. Underwriting. - No insurer shall authorize any micro-insurance agent or any other
outsider to underwrite any insurance proposal for the purpose of granting insurance
cover.

11. Capacity Building: - Every insurer shall impart at least twenty-five hours of training
at its expense and through its designated officer(s) in the local vernacular language to all
micro-insurance agents and their specified persons in the areas of insurance selling,
policyholder servicing and claims administration.

12. Remuneration/ commission.- (1) A micro-insurance agent may be paid,

remuneration for all the functions rendered as outlined in regulation 5 and including
commission, by an insurer, and that the same shall not exceed the limits as stated
below:

(a) For Life Insurance Business:

Single Premium policies - Ten per-cent of the single premium

Non single premium policies - Twenty per cent of the premium for all the years
of the premium paying term

(b) For Non-Life Insurance Business: Fifteen per cent of the premium.

(2) Where the agreement between the micro-insurance agent and insurer is
terminated for any reason whatsoever, no future commission/ remuneration shall be
payable.

(3) For group insurance products, the insurer may decide the commission subject to
the overall limit as specified in sub-regulation (1).

13. Overall compliance.- Every insurer shall ensure that all transactions in connection
with micro-insurance business are in accordance with the provisions of the Act, the
Insurance Regulatory and Development Act, (41 of 1999), and the rules and regulations
made there under.
 13

14. Submission of information.- Every insurer shall furnish information in respect of

micro-insurance business in such form and manner and containing such particulars, as
may be required by the Authority from time to time.

15. Obligations to Rural and Social Sectors> (1) All micro-insurance policies may be
reckoned for the purposes of fulfillment of social obligations by an insurer pursuant to
the provisions of the Act and the regulations made there under.

(2) Where a micro-insurance policy is issued in a rural area and falls under the definition
of social sector, such policy may be reckoned for both under rural and social obligations
separately.

16. Handling of complaints/ grievances.- (1) It shall be the responsibility of the insurer
to handle and dispose of complaints against a micro-insurance agent with speed and
promptitude.

(2) Every insurer shall send a quarterly report to the Authority regarding the handling of
complaints/grievances against the micro-insurance agents and where in a particular
quarter, there are no complaints/grievances, a "Nil" report shall be sent.

17. Inspection by Authority.- The Authority may cause inspection of the office al1d
records of any micro-insurance agent, at any time, if it is deemed necessary.

18. Removal of difficulties.- Where any doubt or difficulty arises in giving effect to the
provisions any of these regulations, the same may be referred to the Authority, whose
decision thereon shall be binding on the parties concerned.

Schedule-I
[See regulation 2( d)]

Ite Type of Cover Min. Max. Term of Term of Min. Age Max. age
m Amount of Amount of Cover Cover at entry at entry
Cover Cover Min. Max.
1 Dwelling & contents, or Rs.5,000 Rs.30,000 I year I year NA NA
livestock or Tools or Per asset! Per asset!
implements or other named cover cover
assets / or Crop msurance
against all perils
2 Health Insurance Contract Rs.5,000 Rs.30,000 1 year 1 year Insurers' discretion
(Ind.)
3 Health Insurance Contract Rs 10,000 Rs.30,000 1 year 1 year Insurers' discretion
(family)
(Option to avail limit for
Individual! Float on family)
4 Personal Accident (per life/ Rs.I0,000 Rs.50,000 1 year 1 year 5 70
eaming member of tinnily)

Note:- The minimum number of members comprising a group shall be at least twenty for
group insurance.
3;2(;8 GI!c-·.$- -{,/
 TIIE GAZETI'E OF INDIA: EXTRAORDINARY [PART m..:.....SEC. 4]
14

Schedule-II
[See regulation 2(e)]

Type of Cover Minimum Maximum Term of Term of Minimum Maximum

Amount of Amount of Cover Cover age at age at entry
Cover Cover Min. Max. entry
Term Insurance Rs.5,000 Rs.50,000 5 year 15 years 18 60
with or without
return of premium
Endowment Rs.5,000 Rs.30,000 5 year 15 years 18 60
Insurance
Health Insurance Rs 5,000 Rs.30,000 1 year 7 year Insurer's Insurer's
Contract discretion discretion
(Individual)
Health Insurance Rs 10,000 Rs 30,000 1 year 7 year Insurer's Insurer's
Contract (Family) discretion discretion
Accident Benefit as Rs. 10,000 Rs.50,000 5 year 15 years 18 60
rider

Notes: 1. Group insurance products may be renewable on a yearly basis

2. The minimum number of members comprising a group shall be at least twenty
for group insurance.

C. S. RAO, Chairman
[AD vr IIVIVI161/2005IExty. ]

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