1 S.No. Annexure-II Disclosures - NON- LIFE INSURANCE COMPANIES Form No Description Annually Halfyearly Quarterly Mode of Disclosure 1 NL-1-B-RA Revenue Account P 2 NL-2-B-PL Profit & Loss Account ** ** P 3 NL-3-B-BS Balance Sheet P 4 NL-4-PREMIUM Premium SCHEDULE 5 NL-5-CLAIMS SCHEDULE Claims Incurred 6 NL-6-COMMISSION Commission SCHEDULE 7 NL-7-OPERATING Operating Expenses EXPENSES SCHEDULE 8 NL-8-SHARE CAPITAL Share Capital SCHEDULE 9 NL-9-PATTERN OF Pattern of Shareholding SHAREHOLDING SCHEDULE 10 NL-10-RESERVE AND Reserves and Surplus SURPLUS SCHEDULE 11 NL-11-BORROWING Borrowings SCHEDULE 12 NL-12-INVESTMENT Shareholders SCHEDULE 13 NL-13-LOANS Loans SCHEDULE 14 NL-14-FIXED ASSETS Fixed Assets SCHEDULE 15 NL-15-CASH AND BANK Cash and Bank Balance BALANCE SCHEDULE 16 NL-16-ADVANCES AND Advances & Other Assets OTHER ASSETS SCHEDULE 17 NL-17-CURRENT Current Liabilities LIABILITIES SCHEDULE 18 NL-18-PROVISIONS Provisions SCHEDULE 19 NL-19-MISC Misc Expenditure EXPENDITURE SCHEDULE 20 NL-20-RECEIPTS AND Receipts & Payment Statement PAYMENT SCHEDULE 21 NL-21-STATEMENT OF Statement of Liablities LIABILITIES 22 NL-22-GEOGRAPHICAL Geographical Distribution of Business DISTN OF BSNS 23 NL-23-REINSURANCE Reinsurance Risk Concentration RISK CONCENTRATION 24 NL-24-AGEING OF Ageing of Claims CLAIMS (within 6 months from the end of the period) (within 2 months from the end of the period) (within 45 days from the end of the period) P X X Annual and half yearly to be published in newspaper as stated below and quarterly to be displayed in electronic format.
2 25 NL-25-CLAIMS DATA Claims Data
3 26 NL-26-CLAIMS Claims Information INFORMATION 27 NL-27-OFFICE OPENING Office Opening 28 NL-28-STATEMENT OF Statement of Investment of Assets ASSETS 29 NL-29-DEBT SECURITIES Debt Securities 30 NL-30-ANALYTICAL Analytical Ratios Ratios stated at Serial number 1 to 15 to be RATIOS published in newspapers along with financial statement and should also be displayed in format. 31 NL-31-RELATED PARTY Related Party Transanctions TRANSACTIONS 32 NL-32-PRODUCT Product Information INFORMATION 33 NL-33-SOLVENCY Solvency MARGIN 34 NL-34-BOD Board of Directors & Management 35 NL-35-NPAs NPAs 36 NL-36-YIELD ON Yield on Investment INVESTMENTS 37 NL-37-DOWN GRADING Downgrading of Investment OF INVESTMENTS 38 NL-38-BSNS RETURNS Quarterly Business Returns for different ACROSS LOB line of business (Premum amount and number of policies) 39 NL-39-RURAL AND Rural & Social Sector Obligations SOCIAL SECTOR OBLIGATIONS 40 NL-40-CHANNEL WISE Business Acquisition through different PREMIUM channels 41 NL-41-GRIEVANCE Grievance Disposal DISPOSAL ** To be Published in atleast one English daily newspaper circulating in the whole or substantially the whole of India and in one newspaper published in the language of the region, where the registered office is situated. However, while publishing only the abridged form of Revenue account classifed into ULIP and NON-ULIP will only be published. The detailed Revenue Account will be displayed on web-site.
5 FORM NL-2-B-PL Name of the Insurer: Registration No. and Date of Registration with the IRDA PROFIT AND LOSS ACCOUNT FOR THE YEAR ENDED 30TH SEPTEMBER 2010 ` in thousands Particulars Schedule For the Qr Upto to the Qr. For the Qr. Upto the Qr. 1 OPERATING PROFIT/(LOSS) (a) Fire Insurance (b) Marine Insurance (c ) Miscellaneous Insurance INCOME FROM INVESTMENTS (a) Interest, Dividend & Rent Gross (b) Profit on sale of investments Less: Loss on sale of investments 3 OTHER INCOME (To be specified) Profit/Loss on sale of assets & other incomes TOTAL (A) PROVISIONS (Other than taxation) (a) For diminution in the value of investments (b) For doubtful debts (c) Others (to be specified) 5 OTHER EXPENSES (a) Expenses other than those related to Insurance Business (b) Bad debts written off (c) Others (To be specified) Amortisation of Premium on Investments Amount written off in respect of depreciated investments TOTAL (B) Profit Before Tax Provision for Taxation Taxation relating to earlier years APPROPRIATIONS (a) Interim dividends paid during the year (b) Proposed final dividend 0 0 (c) Dividend distribution tax 0 0 (d) Transfer to any Reserves or Other Accounts (to be specified) Transferred to General Reserve Balance of profit/ loss brought forward from last year Balance carried forward to Balance Sheet Notes: to Form NL-1-B-RA and NL-2-B- PL (a) Premium income received from business concluded in and outside India shall be separately disclosed. (b) Reinsurance premiums whether on business ceded or accepted are to be brought into account gross (i.e. before deducting commissions) under the head reinsurance premiums. (c) Claims incurred shall comprise claims paid, specific claims settlement costs wherever applicable and change in the outstanding provision for claims at the year-end,. (d) Items of expenses and income in excess of one percent of the total premiums (less reinsurance) or Rs.5,00,000 whichever is higher, shall be shown as a separate line item. (e) Fees and expenses connected with claims shall be included in claims. (f) Under the sub-head "Others shall be included items like foreign exchange gains or losses and other items. (g) Interest, dividends and rentals receivable in connection with an investment should be stated as gross amount, the amount of income tax deducted at source being included under 'advance taxes paid and taxes deducted at source.. (h) Income from rent shall include only the realised rent. It shall not include any notional rent.
6 FORM NL-3-B-BS Name of the Insurer: Registration No. and Date of Registration with the IRDA BALANCE SHEET AS AT ` in thousands Schedule AS AT AS AT SOURCES OF FUNDS SHARE CAPITAL NL-8-Share Capital Schedule SHARE APPLICATION MONEY PENDING ALLOTMENT RESERVES AND SURPLUS NL-10- Reserves and Surplus Schedule FAIR VALUE CHANGE ACCOUNT BORROWINGS NL-11- Borrowings Schedule TOTAL APPLICATION OF FUNDS INVESTMENTS LOANS FIXED ASSETS NL-12- Investment Schedule NL-13-Loans Schedule NL-14-Fixed Assets Schedule
7 DEFERRED TAX ASSET CURRENT ASSETS Cash and Bank Balances Advances and Other Assets NL-15-Cash and bank balance Schedule NL-16- Advancxes and Other Assets Schedule Sub-Total (A) CURRENT LIABILITIES PROVISIONS DEFERRED TAX LIABILITY NL-17-Current Liabilities Schedule NL-18- Provisions Schedule Sub-Total (B) NET CURRENT ASSETS (C) = (A - B) MISCELLANEOUS EXPENDITURE (to the extent not written off or adjusted) DEBIT BALANCE IN PROFIT AND LOSS ACCOUNT NL-19- Miscellaneous Expenditure Schedule TOTAL CONTINGENT LIABILITIES
8 Particulars (Rs. 000) (Rs. 000) 1 Partly paid-up investments Claims, other than against policies, not acknowledged as debts by the company Underwriting commitments outstanding (in respect of shares and securities) Guarantees given by or on behalf of the Company Statutory demands/ liabilities in dispute, not provided for Reinsurance obligations to the extent not provided for in accounts Others (to be specified) 0 0 Letters of credit given on behalf of the company TOTAL
9 FORM NL-5 - CLAIMS SCHEDULE CLAIMS INCURRED [NET] ` in thousands Particulars Fire MARINE CARGO MARINE HULL MARINE TOTAL For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr Claims paid Direct claims Add Claims Outstanding at the end of the year Less Claims Outstanding at the beginning of the year Gross Incurred Claims Add :Re-insurance accepted to direct claims Less :Re-insurance Ceded to claims paid Total Claims Incurred Notes: a) Incurred But Not Reported (IBNR), Incurred but not enough reported [IBNER] claims should be included in the amount for outstanding claims. b) Claims includes specific claims settlement cost but not expenses of management c) The surveyor fees, legal and other expenses shall also form part of claims cost. d) Claims cost should be adjusted for estimated salvage value if there is a sufficient certainty of its realisation. Particulars Motor OD Motor TP Motor Pool Motor Total For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr Claims paid Direct claims Add Claims Outstanding at the end of the year Less Claims Outstanding at the beginning of the year Gross Incurred Claims Add :Re-insurance accepted to direct claims Less :Re-insurance Ceded to claims paid Total Claims Incurred Particulars Workmen Compensation Personal Accident Aviation Engineering For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr Claims paid Direct claims Add Claims Outstanding at the end of the year Less Claims Outstanding at the beginning of the year Gross Incurred Claims Add :Re-insurance accepted to direct claims Less :Re-insurance Ceded to claims paid Total Claims Incurred Particulars Other Miscellaneous Liabilities Health & Hospitalisation Miscellaneous Total For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr Claims paid Direct claims Add Claims Outstanding at the end of the year Less Claims Outstanding at the beginning of the year Gross Incurred Claims Add :Re-insurance accepted to direct claims Less :Re-insurance Ceded to claims paid Total Claims Incurred
10 FORM NL-7-OPERATING EXPENSES SCHEDULE OPERATING EXPENSES RELATED TO INSURANCE BUSINESS ` in thousands Fire Marine Miscellaneous Particulars For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr For the Qr. Upto the Qr 1 Employees remuneration & welfare benefits Travel, conveyance and vehicle running expenses Training expenses Rents, rates & taxes Repairs Printing & stationery Communication Legal & professional charges Auditors' fees, expenses etc (a) as auditor (b) as adviser or in any other capacity, in respect of (i) Taxation matters (ii) Insurance matters (iii) Management services; and (c) in any other capacity Advertisement and publicity Interest & Bank Charges Others (to be specified) Depreciation TOTAL Note: Items of expenses and income in excess of one percent of the total premiums (less reinsurance) or Rs.5,00,000 whichever is higher, shall be shown as a separate line item.
11 FORM NL-8-SHARE CAPITAL SCHEDULE SHARE CAPITAL Particulars (Rs. 000). (Rs. 000). 1 Authorised Capital Equity Shares of Rs.10/ each 2 Issued Capital Equity Shares of Rs.10/ each (includes equity shares of Rs.10 each issued as Bonus shares by capitalisation of General Reserve and Share Premium Account 3 Subscribed Capital Equity Shares of Rs.10/- each (includes equity shares of Rs.10 each issued as Bonus shares by capitalisation of General Reserve and Share Premium Account 4 Called-up Capital Equity Shares of Rs.10/- each (includes equity shares of Rs.10 each issued as Bonus shares by capitalisation of General Reserve and Share Premium Account Less : Calls unpaid Add : Equity Shares forfeited (Amount originally paid up) Less : Par Value of Equity Shares bought back Less : Preliminary Expenses Expenses including commission or brokerage on Underwriting or subscription of shares TOTAL Notes: (a) Particulars of the different classes of capital should be separately stated. (b) The amount capitalised on account of issue of bonus shares should be disclosed. (c) In case any part of the capital is held by a holding company, the same should be separately disclosed.
12 FORM NL-9-PATTERN OF SHAREHOLDING SCHEDULE SHARE CAPITAL PATTERN OF SHAREHOLDING [As certified by the Management] Shareholder As at As at Number of Shares % of Holding Number of Shares % of Holding Promoters Indian - Government of India % Nominees of Govt. of India % Foreign Others TOTAL
13 FORM NL-10-RESERVE AND SURPLUS SCHEDULE RESERVES AND SURPLUS Particulars (Rs. 000). (Rs. 000). 1 Capital Reserve Capital Redemption Reserve 3 Share Premium 4 General Reserves Less: Debit balance in Profit and Loss Account Less: Amount utilized for Buy-back Add: Transfer from Profit & Loss Account Catastrophe Reserve 6 Other Reserves (to be specified) - Investment Reserve Foreign Currency Translation Reserve Opening Addition/(deletions) during the - year Closing Balance Balance of Profit in Profit & Loss Account TOTAL Note: Additions to and deductions from the reserves should be disclosed under each of the specified heads.
14 FORM NL-11-BORROWINGS SCHEDULE BORROWINGS Particulars (Rs. 000) (Rs. 000) 1 Debentures/ Bonds NIL NIL 2 Banks NIL NIL 3 Financial Institutions NIL NIL 4 Others (to be specified) NIL NIL TOTAL NIL NIL Notes: a) The extent to which the borrowings are secured shall be separately disclosed stating the nature of the security under each sub-head. b) Amounts due within 12 months from the date of Balance Sheet should be shown separately
15 FORM NL-12-INVESTMENTS SCHEDULE Particulars (Rs. 000) (Rs. 000) LONG TERM INVESTMENTS Government securities and Government guaranteed bonds including Treasury Bills Other Approved Securities Other Investments ( a) Shares (aa) Equity (bb) Preference ( b) Mutual Funds (c) Derivative Instruments (d) Debentures/ Bonds (e) Other Securities (to be specified) (f) Subsidiaries (g) Investment Properties-Real Estate Investments in Infrastructure and Social Sector Other than Approved Investments SHORT TERM INVESTMENTS Government securities and Government guaranteed bonds including Treasury Bills Other Approved Securities Other Investments (a) Shares (aa) Equity 0 (bb) Preference (b) Mutual Funds (a) Derivative Instruments (b) Debentures/ Bonds (c) Other Securities - commercial papers (d) Subsidiaries (e) Investment Properties-Real Estate Investments in Infrastructure and Social Sector Other than Approved Investments TOTAL (a) Investments in subsidiary/holding companies, joint ventures and associates shall be separately disclosed, at cost. (i) Holding company and subsidiary shall be construed as defined in the Companies Act, 1956: (ii) Joint Venture is a contractual arrangement whereby two or more parties undertake an economic activity, which is subject to joint control. (i) Joint control - is the contractually agreed sharing of power to govern the financial and operating policies of an economic activity to obtain benefits from it.
16 (ii) Associate - is an enterprise in which the company has significant influence and which is neither a subsidiary nor a joint venture of the company. (iii) Significant influence (for the purpose of this schedule) - means participation in the financial and operating policy decisions of a company, but not control of those policies. Significant influence may be exercised in several ways, for example, by representation on the board of directors, participation in the policymaking process, material inter-company transactions, interchange of managerial personnel or dependence on technical information. Significant influence may be gained by share ownership, statute or agreement. As regards share ownership, if an investor holds, directly or indirectly through subsidiaries, 20 percent or more of the voting power of the investee, it is presumed that the investor does have significant influence, unless it can be clearly demonstrated that this is not the case. Conversely, if the investor holds, directly or indirectly through subsidiaries, less than 20 percent of the voting power of the investee, it is presumed that the investor does not have significant influence, unless such influence is clearly demonstrated. A substantial or majority ownership by another investor does not necessarily preclude an investor from having significant influence. (b) Aggregate amount of company's investments other than listed equity securities and derivative instruments and also the market value thereof shall be disclosed. (c) Investments made out of Catastrophe reserve should be shown separately. (d) Debt securities will be considered as held to maturity securities and will be measured at historical cost subject to amortisation. (e) Investment Property means a property [land or building or part of a building or both] held to earn rental income or for capital appreciation or for both, rather than for use in services or for administrative purposes. (f) Investments maturing within twelve months from balance sheet date and investments made with the specific intention to dispose of within twelve months from balance sheet date shall be classified as short-term investments
17 NL-13 LOANS SCHEDULE Particulars (Rs. 000) (Rs. 000) SECURITY-WISE CLASSIFICATION Secured (a) On mortgage of property (aa) In India (bb) Outside India (b) On Shares, Bonds, Govt. Securities (c) Others (to be specified) (Government guaranteed bonds) Unsecured TOTAL BORROWER-WISE CLASSIFICATION (a) Central and State Governments (b) Banks and Financial Institutions (c) Subsidiaries 0 0 (d) Industrial Undertakings (e) Others (to be specified) - Loans to HUDCO Employees Housing Loan TOTAL PERFORMANCE-WISE CLASSIFICATION (a) Loans classified as standard (aa) In India (bb) Outside India (b) Non-performing loans less provisions (aa) In India (bb) Outside India Provisions TOTAL MATURITY-WISE CLASSIFICATION (a) Short Term (b) Long Term TOTAL (a) Short-term loans shall include those, which are repayable within 12 months from the date of balance sheet. Long term loans shall be the loans other than short-term loans. (b) Provisions against non-performing loans shall be shown separately. (c ) The nature of the security in case of all long term secured loans shall be specified in each case. Secured loans for the purposes of this schedule, means loans secured wholly or partly against an asset of the com (d) Loans considered doubtful and the amount of provision created against such loans shall be dis
18 FORM NL-14-FIXED ASSETS SCHEDULE FIXED ASSETS (Rs. 000) Particulars Cost/ Gross Block Depreciation Net Block Opening Additions Deductions Closing Up to Last For The On Sales/ To Date Year Period Adjustments Goodwill Intangibles - Softwares Land-Freehold Leasehold Property Buildings Furniture & Fittings Information Technology Equipment Vehicles Office Equipment Others - Electrical Equipment - Other Assets TOTAL Work in progress Grand Total PREVIOUS YEAR Note: Assets included in land, property and buildingabove exclude Investment Properties as defined in note (e) to Form NL-12-Investment Schedule.
19 FORM NL-15-CASH AND BANK BALANCE SCHEDULE CASH AND BANK BALANCES Particulars FOR THE QUARTER UP TO THE QUARTER (Rs. 000) (Rs. 000) 1 Cash (including cheques, drafts and stamps) 2 Bank Balances (a) Deposit Accounts (aa) Short-term (due within months) (bb) Others (b) Current Accounts (c) Others - Remittances in Transit Money at Call and Short Notice (a) With Banks (b) With other Institutions Others (to be specified) TOTAL Balances with non-scheduled banks included in 2 and 3 above Note : Bank balance may include remittances in transit. If so, the nature and amount should be separately stated.
20 FORM NL-16-ADVANCES AND OTHER ASSETS SCHEDULE ADVANCES AND OTHER ASSETS Particulars As at As at for the corresponding previous year (Rs. 000). (Rs. 000). ADVANCES 1 Reserve deposits with ceding companies 2 Application money for investments Prepayments Advances to Directors/Officers 5 Advance tax paid and taxes deducted at source (Net of provision for taxation) 6 Others Staff Advances and Loans TOTAL (A) OTHER ASSETS 1 Income accrued on investments Outstanding Premiums Agents Balances Foreign Agencies Balances 5 Due from other entities carrying on insurance business (including reinsurers) 6 Due from subsidiaries/ holding 7 Deposit with Reserve Bank of India [Pursuant to section 7 of Insurance Act, 1938] 8 Others Deposits, Advances and Other accounts - Inter Office Adjustments (Net) TOTAL (B) TOTAL (A+B) Notes: (a) The items under the above heads shall not be shown net of provisions for doubtful amounts. The amount of provision against each head should be shown separately. (b) The term officer should conform to the definition of that term as given under the Companies Act, (c) Sundry Debtors will be shown under item 9(others)
21 FORM NL-17-CURRENT LIABILITIES SCHEDULE CURRENT LIABILITIES Particulars As at As at for the corresponding previous year (Rs. 000). (Rs. 000). 1 Agents Balances Balances due to other insurance companies 3 Deposits held on re-insurance ceded 4 Premiums received in advance Unallocated Premium 6 Sundry creditors Due to subsidiaries/ holding company 8 Claims Outstanding Due to Officers/ Directors 10 Others Former shareholders fund TOTAL
22 FORM NL-18-PROVISIONS SCHEDULE PROVISIONS Particulars As at As at for the corresponding previous year (Rs. 000). (Rs. 000). 1 Reserve for Unexpired Risk For taxation (less advance tax paid and taxes deducted at source) 3 For proposed dividends For dividend distribution tax Others (to be specified) Provision for diminution in value of other than actively traded Equities For Leave Encashment Provision for Employee Short term Benefits For Wage Arrears For Loans, Investments and Other Assets Reserve for Premium Deficiency TOTAL
23 FORM NL-19 MISC EXPENDITURE SCHEDULE MISCELLANEOUS EXPENDITURE (To the extent not written off or adjusted) Notes: Particulars As at As at for the corresponding previous year (Rs. 000). (Rs. 000). 1 Discount Allowed in issue of NIL NIL shares/ debentures 2 Others (to be specified) NIL NIL TOTAL NIL NIL (a) No item shall be included under the head Miscellaneous Expenditure and carried forward unless: 1. some benefit from the expenditure can reasonably be expected to be received in future, and 2. the amount of such benefit is reasonably determinable. (b) The amount to be carried forward in respect of any item included under the head Miscellaneous Expenditure shall not exceed the expected future revenue/other benefits related to the expenditure.
24 FORM NL-20-RECEIPT AND PAYMENTS SCHEDULE Format of Receipts and Payments A/c to be furnished by the insurers on direct basis (Rs in '000's) Cash Flows from the operating activities: Premium received from policyholders, including advance receipts Other receipts Payments to the re-insurers, net of commissions and claims Payments to co-insurers, net of claims recovery Payments of claims Payments of commission and brokerage Payments of other operating expenses Preliminary and pre-operative expenses Deposits, advances and staff loans Income taxes paid (Net) Service tax paid Other payments Cash flows before extraordinary items Cash flow from extraordinary operations Net cash flow from operating activities Cash flows from investing activities: Purchase of fixed assets Proceeds from sale of fixed assets Purchases of investments Loans disbursed Sales of investments Repayments received Rents/Interests/ Dividends received Investments in money market instruments and in liquid mutual funds (Net)* Expenses related to investments Net cash flow from investing activities Cash flows from financing activities: Proceeds from issuance of share capital Proceeds from borrowing Repayments of borrowing Interest/dividends paid Net cash flow from financing activities Effect of foreign exchange rates on cash and cash equivalents, net Net increase in cash and cash equivalents: Cash and cash equivalents at the beginning of the year Cash and cash equivalents at the end of the year *Investments in mutual funds where these are used as parking vehicles pending investment are to be indicated (net).
26 NL_21_Liab IRDA Periodic Disclosures FORM NL-21 Statement of Liabilities PERIODIC DISCLOSURES Insurer: UNITED INDIA INSURANCE COMPANY LTD Date: (Rs in Lakhs) Statement of Liabilities As At As at for the corresponding previous year Sl.No. Particular Reserves for Reserve for Reserves for Reserve for IBNR Reserves Total Reserves unexpired risks Outstanding Claims unexpired risks Outstanding Claims IBNR Reserves Total Reserves 1 Fire Marine a Marine Cargo b Marine Hull Miscellaneous a Motor b Engineering c Aviation d Liabilities e Others Health Insurance Total Liabilities Page 26 of 56
27 NL_22_Geog Dist Bsns IRDA Periodic Disclosures FORM NL-22 Geographical Distribution of Business PERIODIC DISCLOSURES (Rs in Lakhs) Insurer: Date: GROSS DIRECT PREMIUM UNDERWRITTEN FOR THE QUARTER: Overseas All Other Marine Marine Engineerin Motor Own Motor Third Liability Personal Medical medical Crop Miscellane STATES Fire (Cargo) (Hull) g Damage Party insurance Accident Insurance Insurance Insurance ous Grand Total For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr For the qtr Upto the qtr Page 27 of 56
28 NL_23_Risk RI Conc IRDA Periodic Disclosures FORM NL-23 Reinsurance Risk Concentration PERIODIC DISCLOSURES Insurer: Date: (Rs in Lakhs) Reinsurance Risk Concentration S.No. Reinsurance Placements No. of reinsurers Premium ceded to reinsurers Proportional Non-Proportional Facultative Premium ceded to reinsurers / Total reinsurance premium ceded (%) 1 No. of Reinsurers with rating of AAA and above 2 No. of Reinsurers with rating AA but less than AAA 3 No. of Reinsurers with rating A but less than AA 4 No. of Reinsurers with rating BBB but less than A 5 No. of Reinsurres with rating less than BBB 6 Total Page 28 of 56
29 NL_24_Age Clm IRDA Periodic Disclosures FORM NL-24 Insurer: Ageing of Claims PERIODIC DISCLOSURES Date: (Rs in Lakhs) Ageing of Claims Sl.No. 1 Fire Line of Business 2 Marine Cargo 3 Marine Hull 4 Engineering 5 Motor OD 6 Motor TP 7 Health 8 Overseas Travel 9 Personal Accident 10 Liability 11 Crop 12 Miscellaneous No. of claims paid 1 month 1-3 months 3-6 months 6 months - 1 year > 1 year Total No. of claims paid Total amount of claims paid Page 29 of 56
30 NL_25_Clm Data IRDA Periodic Disclosures FORM NL-25 : Quarterly claims data for Non-Life PERIODIC DISCLOSURES Insurer: Date: Sl. No. No. of claims only Overse Persona Marine Marine Engine Motor Motor Miscell Claims Experience Fire Health as l Liability Crop Credit Total Cargo Hull ering OD TP aneous Travel Accident 1 Claims O/S at the beginning of the period 2 Claims reported during the period 3 Claims Settled during the period 4 Claims Repudiated during the period 5 Claims closed during the period 6 Claims O/S at End of the period Less than 3months 3 months to 6 months 6months to 1 year 1year and above Page 30 of 56
31 FORM NL-26 - CLAIMS INFORMATION - KG Table I Insurer : Solvency for the quarter ended Required solvency margin based on net premium and net incurred claims (Rs. in Lacs) PREMIUM Item Gross Net Gross incurred Net incurred No. Description Premium Premium claim Claim RSM-1 RSM-2 RSM 1 Fire Marine Cargo Marine Hull Motor Engineering Aviation Liabilities Others Health Total
32 NL_27_Off Op IRDA Periodic Disclosures FORM NL-27 Insurer: PERIODIC DISCLOSURES Offices information for Non-Life Date: Sl. No. Office Information Number 1 No. of offices at the beginning of the year 2 No. of branches approved during the year 3 No. of branches opened during the year 4 year 5 No. of branches closed during the year 6 No of branches at the end of the year 7 No. of branches approved but not opend 8 No. of rural branches 9 No. of urban branches Out of approvals of previous year Out of approvals of this Page 32 of 56
33 FORM NL-28-STATEMENT OF ASSETS - 3B Company Name & Code: Statement as on: Statement of Investment Assets (General Insurer, Re-insurers) (Business within India) Periodicity of Submission: Quarterly Rs. In Lakhs No PARTICULARS SCH AMOUNT 1 Investments 8 2 Loans 9 3 Fixed Assets 10 4 Current Assets a. Cash & Bank Balance 11 b. Advances & Other Assets 12 5 Current Liabilities a. Current Liabilities 13 b. Provisions 14 c. Misc. Exp not Written Off 15 d. Debit Balance of P&L A/c Application of Funds as per Balance Sheet (A) 0 Less: Other Assets SCH Amount 1 Loans (if any) 9 2 Fixed Assets (if any) 10 3 Cash & Bank Balance (if any) 11 4 Advances & Other Assets (if any) 12 5 Current Liabilities 13 6 Provisions 14 7 Misc. Exp not Written Off 15 8 Debit Balance of P&L A/c TOTAL (B) 0 'Investment Assets' As per FORM 3B (A-B) 0
34 No 'Investment' represented as Reg. % 1 G. Sec. 2 G. Sec or Other Apporved Sec. (incl. (1) above) 3 Investment subject to Exposure Norms 1. 'Housing & Loans to SG for Housing and FFE, Infrastructure Investments 2. Approved Investments 3. Other Investments (not exceeding 25%) Not less than 20% Not less than 30% Not less than 15% Not exceeding 55% SH Book Value FVC PH Total Balance (SH + PH) % FRSM + Amount Actual (a) (b) (c) d = (b+c) (e) (d + e) Total Investment Assets 100% - Certification: Certified that the information given herein are correct and complete to the best of my knowledge and belief and nothing has been concealed or suppressed Date: Signature: Full name: Designation: Note: (+) FRMS refers 'Funds representing Solvency Margin' (*) Pattern of Investment will apply only to SH funds representing FRMS ( A ) Book Value shall not include funds beyond Solvency Margin Other Investments' are as permitted under Sec 27A(2) and 27B(3)
36 Market Value -
37 NL_29_Debt Sec IRDA Periodic Disclosures FORM NL-29 Detail regarding debt securities PERIODIC DISCLOSURES Insurer: Date: As at. (Rs in Lakhs) Detail Regarding debt securities MARKET VALUE as % of total for as at. Of the as % of total for As at. this class previous year this class as % of total for this class Book Value as at. Of the previous year as % of total for this class Break down by credit rating AAA rated AA or better Rated below AA but above A Rated below A but above B Any other BREAKDOWN BY RESIDUALMATURITY Up to 1 year more than 1 yearand upto 3years More than 3years and up to 7years More than 7 years and up to 10 years above 10 years Breakdown by type of the issurer a. Central Government b. State Government c.corporate Securities Page 37 of 56
38 NL_30_Ana Rat IRDA Periodic Disclosures FORM NL-30 Analytical Ratios PERIODIC DISCLOSURES Insurer: Date: (Rs in Lakhs) Analytical Ratios for Non-Life companies Sl.No. Particular For the quarter up to the Quarter Corresponding quarter of up to the Quarter of the the preceeding year prceeding year 1 Gross Premium Growth Rate 19.29% 22.08% 26.27% 21.85% 2 Gross Premium to shareholders' fund ratio 36.00% 76.54% 34.45% 72.05% 3 Growth rate of shareholders'fund 2.86% 5.65% 8.26% 11.94% 4 Net Retention Ratio 82.36% 79.57% 82.12% 79.89% 5 Net Commission Ratio 5.55% 5.45% 5.37% 5.57% 6 Expense of Management to Gross Direct Premium Ratio 29.30% 24.77% 25.54% 22.73% 7 Combined Ratio % % % % 8 Technical Reserves to net premium ratio % % % % 9 Underwriting balance ratio % % % % 10 Operationg Profit Ratio -5.87% -4.92% 14.68% 7.56% 11 Liquid Assets to liabilities ratio 55.52% 55.56% 12 Net earning ratio 9.60% 8.61% 29.22% 20.85% 13 return on net worth ratio 2.78% 4.99% 7.64% 10.73% 14 Available Solvency Margin Ratio to Required Solvency Margin Ratio NPA Ratio Gross NPA Ratio 0.01% 1.07% Net NPA Ratio 0.00% 0.15% Equity Holding Pattern for Non-Life Insurers (Rs in Lakhs) 1 (a) No. of shares (b) Percentage of shareholding (Indian / Foreign) 100% / 0% 100% / 0% 100% / 0% 100% / 0% 3 ( c) %of Government holding (in case of public sector insurance companies) % % % % (a) Basic and diluted EPS before extraordinary items 4 (net of tax expense) for the period (not to be annualized) (b) Basic and diluted EPS after extraordinary items 5 (net of tax expense) for the period (not to be annualized) 6 (iv) Book value per share (Rs) Page 38 of 56
39 NL_31_Rel Par IRDA Periodic Disclosures FORM NL-31 PERIODIC DISCLOSURES : Related Party Transactions Insurer: Sl.No Name of the Related Party (Rs in Lakhs) Date: Related Party Transactions Nature of Relationship with the Company Description of Transactions / Categories For the quarter Consideration paid / received* up to the Quarter Correspodning quarter of the preceeding year up to the Quarter of the prceeding year *including the premium flow through Assocaites/ Group companies as an agent Page 39 of 56
40 NL_32_Prod IRDA Periodic Disclosures FORM NL-32 Products Information PERIODIC DISCLOSURES Insurer: Date: List below the products and/or add-ons introduced during the period Products Information Sl. No. Name of Product Co. Ref. No. IRDA Ref.no. Class of Business* Category of product Date of filing of Product Date IRDA confirmed filing/ approval n Page 40 of 56
41 FORM NL-33 - SOLVENCY MARGIN - KGII TABLE - II Insurer: UNITED INDIA INSURANCE COMPANY LIMITED Solvency for the Quarter ended on 30TH SEPTEMBER 2010 Available Solvency Margin and Solvency Ratio (Rs. in Lacs) Item Description Notes No. Amount (1) (2) (3) (4) 1 Available Assets in Policyholders Funds (adjusted value Form AA of Assets as mentioned in Form IRDA-Assets-AA): Deduct: 2 Liabilities (reserves as mentioned in Form HG) Form HG Other Liabilities (other liabilities in respect of Annx.I Policyholders Fund as mentioned in Balance Sheet) 4 Excess in Policyholders Funds (1-2-3) Available Assets in Shareholders Funds (value of Form AA Assets as mentioned in Form IRDA-Assets-AA): Deduct: 6 Other Liabilities (other liabilities in respect of Annx.I Shareholders Fund as mentioned in Balance Sheet) 7 Excess in Shareholders Funds (5-6) Total Available Solvency Margin [ASM] (4+7) Total Required Solvency Margin [RSM] Solvency Ratio (Total ASM/Total RSM) 3.77
42 NL_34_BOD FORM NL-34 Page 42 of 56 IRDA Periodic Disclosures PERIODIC DISCLOSURES : Board of Directors & Key Person Insurer: Date: BOD and Key Person information Sl. No. Name of person Role/designation Details of change in the period 1 2 n Key Pesons as defined in IRDA Registration of Companoies Regulations, 2000
43 NL_34_BOD FORM NL-34 Page 43 of 56 IRDA Periodic Disclosures PERIODIC DISCLOSURES : Board of Directors & Key Person
44 FORM NL-35-NON PERFORMING ASSETS-7A Company Name & Code: Statement as on: Details of Investment Portfolio Periodicity of Submission : Quarterly Name of the Fund COI Company Name Instrument Type Interest Rate Default Default Total O/s Principal Interest Due Deferred Deferred Rolled Principal Interest (Book Has there (Book Value) Due from from Principal Interest Over? (Book Value) Value) % been Amount revision? Has there been any Principal Waiver? Board Approval Ref Classification Provision (%) Provision (Rs) CERTIFICATION Certified that the information given herein are correct and complete to the best of my knowledge and belief and nothing has been concealed or suppressed. Date: Signature Full Name & Designation Note: A. Category of Investmet (COI) shall be as per INV/GLN/001/ B.FORM 7A shall be submitted in respect of each 'fund'. C. Classification shall be as per F&A-Circulars-169-Jan-07 Dt J HARI NARAYAN, CHAIRMAN [ADVT/III/IV/161/Exty.]
45 FORM NL-36-YIELD ON INVESTMENTS 1 Company Name & Code: Statement as on: Name of the Fund Statement of Investment and Income on Investment Periodicity of Submission: Quarterly Current Quarter Year to Date Pr No. Category of Investment Category Code Investment (Rs.) Income on Investment (Rs.) Income on Gross Yield Net Yield Gross Yield Net Yield Investment (Rs.) Investment Investment (%)¹ (%)² (%)¹ (%)² (Rs.) (Rs.) Book Value Market Value Book Value Market Value Book Value Market Value TOTAL CERTIFICATION Certified that the information given herein are correct and complete to the best of my knowledge and belief and nothing has been concealed or suppressed. Date: Note: Category of Investment (COI) shall be as per Guidelines 1 To be calculated based on Monthly or lesser frequency 'Weighted Agerage' of Investments 2 Yield netted for Tax 3 FORM-1 shall be prepared in respect of each fund.
46 Rs. Lakhs revious Year Income on Gross Yield Investment (%)¹ (Rs.) Net Yield (%)² Signature Full Name & Designation
47 FORM NL-37-DOWN GRADING OF INVESTMENT-2 Company Name & Code: Statement as on: Name of Fund Statement of Down Graded Investments Periodicity of Submission: Quarterly Date of Rating Original No Name of the Security COI Amount Current Grade Purchase Agency Grade Date of Downgrade A. During the Quarter ¹ B. As on Date ² CERTIFICATION Certified that the information given herein are correct and complete to the best of my knowledge and belief and nothing has been concealed or suppressed. Signature Date: Full Name and Designation Note: 1 Provide details of Down Graded Investments during the Quarter. 2 Investments currently upgraded, listed as Down Graded during earlier Quarter shall be deleted from the Cumulative listing. 3 FORM-2 shall be prepared in respect of each fund.
48 4 Category of Investmet (COI) shall be as per INV/GLN/001/
49 Rs. Lakhs Remarks
51 PERIODIC DISCLOSURES FORM NL-38 Quarterly Business Returns across line of Business Insurer: Sl.No. 1 Fire 2 Cargo & Hull 3 Motor TP 4 Motor OD Line of Business 5 Engineering 6 Workmen's Compensation 7 Employer's Liability 8 Aviation 9 Personal Accident 10 Health 11 Others* Note: 1. Premium stands for amount of premium Date: (Rs in Lakhs) Quarterly Business Returns across line of Business 2. The line of business which are not applicable for any company should be filled up with NA. Figure '0' in those fields will imply no business in the segment. *any other segment contributing more than 5% of the total premium needs to be shown separately (Rs in Lakhs) Current Quarter Same Quarter previous year Premium No. of Policies Premium No. of Policies
52 upto the period same period of the previos year Premium No. of Policies Premium No. of Policies
53 FORM NL-39 Insurer: PERIODIC DISCLOSURES Rural & Social Obligations (Quarterly Returns) Date: (Rs in Lakhs) Rural & Social Obligations (Quarterly Returns) Sl.No. Line of Business Particular No. of Policies Issued Premium Collected Sum Assured 1 Fire Rural Social 2 Cargo & Hull Rural Social 3 Motor TP Rural Social 4 Motor OD Rural Social 5 Engineering Rural Social 6 Workmen's Compensation Rural Social 7 Employer's Liability Rural Social 8 Aviation Rural Social 9 Personal Accident Rural Social 10 Health Rural Social 11 Others* Rural Social *any other segment contributing more than 5% needs to be shown separately
54 PERIODIC DISCLOSURES FORM NL-40 Business Acquisition through different channels Insurer: Date: (Rs in Lakhs) Business Acquisition through different channels Current Quarter Same quarter Previous Year Up to the period Same period of the previous year Sl.No. Channels 1 Individual agents 2 Corporate Agents-Banks 3 Corporate Agents -Others 4 Brokers 5 Micro Agents 6 Direct Business Total (A) 1 Referral (B) Grand Total (A+B) No. of Policies Premium No. of Policies Premium No. of Policies Premium No. of Policies Premium Note: 1. Premium means amount of premium received from business acquired by the source 2. No of Policies stand for no. of policies sold
55 FORM NL-41 GREIVANCE DISPOSAL PERIODIC DISCLOSURES Insurer: Date: Sl No. (Rs in Lakhs) GRIEVANCE DISPOSAL Particulars Opening Balance * Additions Complaints Resolved Fully Accepted Partial Accepted Rejected 1 Complaints made by customers 0 0 a) Sales Related b) Policy Administration Related c) Insurance Policy Coverage related d) Claims related e) others d) Total Number Complaints made by Complaints made by 2 Duration wise Pending Status customers intermediaries Total a) Less than 15 days 0 b) Greater than 15 days 0 Total Number * Opening balance should tally with the closing balance of the previous financial year.
56 Complaints Pending