NOTIFICATION OF INTENTION TO CEASE TO ENTER INTO ANY MORE LONG-TERM OR SHORT-TERM POLICIES

NOTIFICATION OF INTENTION TO CEASE TO ENTER INTO ANY MORE LONG-TERM OR SHORT-TERM POLICIES IN TERMS OF SECTION 13(2)(b) OF THE LONG-TERM INSURANCE ACT OR THE SHORT-TERM INSURANCE ACT (“ACT”)

A. Instructions for completion and submission

1. This form must be properly completed and signed. Questions must be answered either in full or not applicable (“n/a”). The signer(s) must be duly authorised to furnish the information.

2. The format of this form or the wording of questions may not be changed. However, this form may be reproduced.

3. Answers may be in writing or may be typed.

3.1 If the form is completed on a computer, -

(a) delete the solid lines in those areas provided for answers before the answers are typed or use the overtype mode whilst the answers are typed.


(b) rows may be inserted where insufficient space is provided for answers.

3.2 If the form is completed by hand, should the space provided not be sufficient, the detail can be provided on a separate page, duly cross-referenced to the relevant question.

3.3 If the form that is submitted contains any changes to typed or written information, those changes must be signed.

4. The completed form does not need to be accompanied by any number of copies.

B. General information

1. This form is required in terms of section 3(2)(b)(ii) of the Act read with section 13(2)(b) of the Act.

2. The Registrar, in terms of section 4(2) of the Act, may by notice direct a long-term or short-term insurer (“insurer”) to furnish the Registrar, within a specified period, with specified additional information or documents.

3. Terms used in this document will have the same meaning as defined in the Act.

4. The information in this document is confidential and not available for inspection by the public.

C. Legal and policy framework

In terms of section 13(2)(b) of the Act the Registrar shall, if a long-term or short-term insurer has notified the Registrar of its intention to cease to enter into any more long-term or short-term policies and has requested so in writing, by notice direct the insurer concerned, with effect from a date specified in the notice, not to enter into any more long-term or short-term policies and require it to make arrangements satisfactory to the Registrar to discharge its obligations under all long-term or short-term policies entered into before the specified date and, when the Registrar is satisfied that the insurer concerned no longer has any obligations under any such policy, shall, by notice to the insurer and in the Government Gazette, cancel its registration.

D. Specific information

1. State the name of the insurer in connection with which this form is completed.

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2. Indicate all the kinds of policies that the insurer is registered for and those policies that the insurer intends to cease to enter into.

2.1 Long-term policies1.

Policy registered for / Mark applicable box with an “X” / Policy ceased to be entered into / Mark applicable box with an “X”
Assistance / Assistance
Disability / Disability
Fund / Fund
Health / Health
Life / Life
Sinking fund / Sinking fund

1. Do not complete if the notification is in respect of short-term policies.

2.2 Short-term policies2.

Policy registered for / Mark applicable box with an “X” / Policy ceased to be entered into / Mark applicable box with an “X”
Accident and health / Accident and health
Engineering / Engineering
Guarantee / Guarantee
Liability / Liability
Miscellaneous / Miscellaneous
Motor / Motor
Property / Property
Transportation / Transportation

2. Do not complete if the notification is in respect of short-term policies.

3. State the date on which the insurer decided to cease to enter into any more policies.

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4. State the date with effect from which the insurer will cease to enter into any more policies.

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5. Furnish full reasons why the insurer decided to cease to enter into any more policies.

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6. Indicate who decided to cease to enter into any more policies.

Members1
Board of directors2

6.1 1. Kindly –

(a) furnish a copy of the notices of the passing of a special resolution by the members of the insurer.

(b) furnish a copy of the special resolution by the members of the insurer.

6.2 2. Kindly furnish a copy of the resolution by the board of directors of the insurer.

7. Is the decided to cease to enter into any more policies temporally or permanent?

Temporally3
Permanent

3. If the answer is “Temporally” kindly furnish details.

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8. Furnish details of the arrangements by the insurer to discharge its obligations under all the policies in question 2.1 or 2.2 of Part D entered into before the date in question 4 of Part D.

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9. Indicate the manner in which the board and executive management will monitor the run-off of the business.

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10. Furnish details of every function that will be outsourced together with an indication of the control and reporting measures associated with each function.

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11. Furnish full details of any reinsurance arrangements that are, or will be put, in place.

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12. Furnish details of the policy of the insurer in communicating with its policyholders and other stakeholders regarding, and during, the run-off of the business.

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13. State the expected date on which the last claim will be disposed of and that the insurer will no longer have any obligations under any policies.

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14. Furnish details of the staff complement of the insurer during the run-off of the business, distinguishing between permanent and temporary staff.

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15. Does the insurer have contingent liabilities contemplated in section 34(1)(d) of the Long-term Insurance Act or section 33(1)(d) of the Short-term Insurance Act?

Yes4
No

4. If the answer is “Yes” kindly furnish details.

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16. Are there any matters that might endanger the maintenance of financially sound condition as envisaged in section 29 of the Long-term Insurance Act or section 28 of the Short-term Insurance Act during the run-off period?

Yes5
No

5. If the answer is “Yes” kindly furnish details.

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17. Did the insurer inform its auditor(s) and statutory actuary (where one is appointed) of this notification?

Yes
No6

6. If the answer is “No” kindly explain.

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18. Are there any other information or documents that are relevant to this form?

Yes7
No

7. If the answer is “Yes” kindly specify the information or documents.

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19. I hereby enclose -

19.1 copies of the notice and resolution in question 6.1 or 6.2 of Part D.

19.2 the documents, if any, mentioned in the Part D in support of the information in this form.

20. I certify, to the best of my knowledge, that the information given in the answers to the above questions are complete, accurate and true and not misleading in any respect.

Full forename(s) and surname of public officer.

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SIGNATURE OF PUBLIC OFFICER DATE

Date of design of document: 01/08/2003 Page 11