1. INTRODUCTION, PURPOSE AND SCOPE

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1 Solvency Assessment and Management: Pillar I - Sub Committee Technical Provisions Task Group Discussion Document 29 (v 5) Authorisation classes of business under SAM EXECUTIVE SUMMARY SAM is a fundamental review of the solvency regime for South African insurers and reinsurers, planned to take effect from January It aims to establish a revised set of capital requirements, valuation techniques and disclosure and risk management standards that will replace and / or enhance most of the current legislative requirements contained in the Long-term Insurance Act (Act No.52 of 1998) and the Short-term Insurance Act (Act No. 53 of 1998). The new regime is expected to apply to all insurers and represents a shift towards risk-based regulation for insurers and reinsurers. A comparison of the Solvency II directive authorisation classes with international regulatory standards and approaches in other jurisdictions was completed. The long-term merits of changing the current authorisation classes outweigh the benefits of retaining the current authorisation classes. For life and non-life the recommendation is to adopt the authorisation classes as set out in the Solvency II directive with a number of amendments to better suit the SA environment. It is noteworthy that the practical consequences of this proposed change are not insignificant. 1. INTRODUCTION, PURPOSE AND SCOPE The principle of authorisation is one of the first steps of risk management within the industry, whereby the regulator needs to authorise (re)insurers to conduct or re within South Africa. The purpose of this authorisation will be to ensure that current and prospective insurers and reinsurers are able to meet the minimum requirements as laid down by the Regulator and that the resources available to the (re)insurer are sufficient for the risks it is absorbing. This discussion document considers authorisation classes as set out in the Solvency II Directive and compares international best practice and regulatory guidance in recommending authorisation classes of business (both life and non-life) for use within SAM. Entities established through the following legislation in South Africa are excluded from the scope of authorisation classes covered in this discussion document because of the social security fund characteristics found, to varying degrees, in their respective business models: Compensation for Occupational Injuries and Diseases Act 130 of 1993; Road Accident Fund Act 56 of 1996 (RAF); Unemployment Insurance Act 63 of 2001; and Medical Schemes Act 131 of At this point legislation for micro- is being developed, which is also excluded from the scope of authorisation classes covered in this Discussion Document.

2 There is a link between the authorisation classes and other elements of SAM, for example: a) Grouping of business for calculating technical provisions; b) Grouping of business for calculating capital requirements; and c) Business classes for reporting and disclosure under Pillar III. Generally the term segmentation is used to refer to the above instances where business is grouped in a homogeneous manner for the purpose at hand. It is sensible for the authorisation classes and segmentation to have similarities, but the authorisation classes / segmentation requirements for these different purposes should not necessarily be the same. The segmentation used for different purposes should depend on what is best for that purpose. This document focuses on authorisation classes of business, while segmentation for other purposes will be considered in separate discussion documents. The Discussion Document contains the research conducted by the Technical Provisions Task Group in terms of the authorisation classes of business, as reviewed by the FSB. This included a review of the following: IAIS Insurance Core Principles ( ICPs ); Solvency II Directive articles relevant to authorisation together with Annex I and Annex II; CEIOPS guidance and QIS5; APRA authorisation classes; OSFI authorisation classes; and Current Long-term Insurance Act and Short-term Insurance Act authorisation classes. The recommendations contained in this Discussion Document will form the basis of other discussion documents being compiled in the Technical Provisions, the Capital Requirements and the Reporting and Disclosures Task Groups. 2. INTERNATIONAL STANDARDS: IAIS ICPs Since its inception in 1994, the IAIS has developed a number of principles and standards in guidance papers to help promote the global development of well-regulated markets. A further objective of the IAIS is to contribute to broader stability of the financial system. The current Insurance Core Principles ( ICPs ), in-force since October 2011, were considered in particular ICP 4 pertaining to the licensing of insurers. ICP 4 Licensing A legal entity which intends to engage in activities must be licensed before it can operate within a jurisdiction. The requirements and procedures for licensing must be clear, objective and public, and be consistently applied. This ICP primarily describes the licensing process from a regulatory point of view. However, the standard under ICP 4.9 states that: A licence clearly states its scope Furthermore, guidance to this standard states that: A licence should clearly state the classification of activities that the insurer is licensed to conduct. Regarding classification, legislation should categorise business into types and classes of (at least into life and nonlife) Page 2 of 38

3 The ICP, standards and guidance are however not prescriptive with respect to the authorisation classes of business. In particular, the regulator has liberty to specify its authorisation classes provided the licensing requirements and procedures are clear, objective, publicly available and consistently applied. 3. EU DIRECTIVE ON SOLVENCY II: PRINCIPLES (LEVEL 1) The following articles are the main sources and guidance on authorisation classes in the Solvency II Directive: Article 14: Principle of authorisation o o 14.1: The taking up of the business of direct or of re covered by this Directive shall be subject to prior authorisation. 14.2: The authorisation referred to in paragraph 1 shall be sought from the supervisory authorities of the home Member State by the following: a) any undertaking which is establishing its head office within the territory of that State; b) any undertaking which, having received an authorisation pursuant to paragraph 1, wishes to extend its business to an entire class or to classes other than those already authorised. Article 15: Scope of authorisation o o o o 15.2: Subject to article 14 (Principle of authorisation), authorisation shall be granted for a particular class of direct as listed in Part A of Annex I or in Annex II. It shall cover the entire class, unless the applicant wishes to cover only some of the risks pertaining to that class. The risks included in a class shall not be included in any other class except in the cases referred to in article 16 (Ancillary risks). Authorisation may be granted for two or more of the classes, where the national law of a Member State permits such classes to be pursed simultaneously. 15.3: In regard to non-life, Member States may grant authorisation for the groups of classes listed in Part B of Annex I. The supervisory authorities may limit authorisation requested for one of the classes to the operations set out in the scheme of operations referred to in article 23 (Scheme of operations). 15.4: Undertakings subject to this Directive may engage in the assistance activity referred to in article 6 (Assistance) only if they have received authorisation for class 18 of Part A of Annex I, without prejudice to Article In that event this Directive shall apply to the operations in question. 15.5: In regard to re, authorisation shall be granted for non-life re activity, life re activity or all kinds of re activity. The application for authorisation shall be considered in the light of the scheme of operations to be submitted pursuant to Article 18(1)(c) (Conditions for authorisation) and the fulfilment of the conditions laid down for authorisation by the Member State from which the authorisation is sought. Article 16: Ancillary risks o 16.1: An undertaking which has obtained an authorisation for a principal risk belonging to one class or group of classes as set out in Annex I may also insure risks included in another class without the need to obtain authorisation in respect of such risks provided that the risks fulfil all the following conditions: a) They are connected with the principal risk b) They concern the object which is covered against the principal risks and c) They are covered by the contract insuring principal risk. Page 3 of 38

4 o 16.2: By way of derogation from paragraph 16.1, the risks included in classes 14, 15 and 17 of Part A of Annexure I shall not be regarded as risks ancillary to other classes. However, legal expenses as set out in Class 17 may be regarded as a risk ancillary to class 18, where the conditions laid down in paragraph 1 and either of the following conditions are fulfilled: a) The main risks relates solely to the assistance provided for persons who fall into difficulties while travelling, while away from their home or their habitual residence; or b) The concerns disputes or risks arising out of, or in connection with, the use of sea-going vessels. Other articles in the Solvency II Directive relevant either directly or indirectly to authorisation classes include: Article 18: Conditions for authorisation Article 25: Refusal of authorisation Article 73: Pursuit of life and non-life activity The following article in the Solvency II Directive relates to the segmentation of classes in the calculation of technical provisions (and not authorisation), but has also been considered in this discussion document. Article 80: Segmentation Annex I of the Directive: CLASSES OF NON-LIFE INSURANCE : Part A: Annex I of Directive 2009/138/EC (Solvency II), part A of Annex I has classified risks according to the following classes and has provided accompanying descriptions and detail: Number and Class Description / Detail 1. Accident Including industrial injury and occupational diseases Fixed pecuniary benefits Benefits in the nature of indemnity Combinations of the two Injury to passengers 2. Sickness Fixed pecuniary benefits Benefits in the nature of indemnity Combinations of the two 3. Land vehicles Other than railway rolling stock All damage to or loss of: o Land motor vehicles o Land vehicles other than motor vehicles 4. Railway rolling stock All damage to or loss of railway rolling stock 5. Aircraft All damage to or loss of aircraft 6. Ships Sea, lake and river and canal vessels All damage to or loss of: o River and canal vessels o Lake vessels o Sea vessels Page 4 of 38

5 Number and Class 7. Goods in transit Including merchandise, baggage, and all other goods Description / Detail All damage to or loss of goods in transit or baggage, irrespective of the form of transport. 8. Fire and natural forces 9. Other damage to property All damage to or loss of property (other than property included in classes 3, 4, 5, 6, and 7) due to: o Fire o Explosion o Storm o Natural forces other than storm o Nuclear energy All damage to or loss of property (other than property included in classes 3, 4, 5, 6 and 7) due to hail or frost, and any event such as theft, other than that included in class Motor vehicle liability All liability arising out of the use of motor vehicle operating on the land (including carrier s liability). 11. Aircraft liability All liability arising out of the use of aircraft (including carrier s liability). 12. Liability for ships Sea, lake and river and canal vessels All liability arising out of the use of ships, vessels or boats on the sea, lakes, rivers of canals (including carrier s liability). 13. General liability All liability other than those referred to in classes 10, 11 and Credit Insolvency (general) Export credit Instalment credit Mortgages Agricultural credit 15. Suretyship Suretyship (direct) Suretyship (indirect) 16. Miscellaneous financial loss Employment risk Insufficiency of income (general) Bad weather Loss of benefits Continuing general expenses Unforeseen trading expenses Loss of market value Loss of rennet or revenue Other indirect trading loss Other non-trading financial loss Other forms of financial loss Page 5 of 38

6 Number and Class Description / Detail 17. Legal expenses Legal expenses and costs of litigation. 18. Assistance Assistance for persons who get info difficulties while travelling, while away from their home or their habitual residence. Part B: The Solvency II Directive, part B of Annex I indicates further that the following names shall be given to authorisations which simultaneously cover the following non-life classes: Name 1. Accident and Health Insurance Class 1: Accident and Class 2: Sickness Classes combined 2. Motor Insurance Class 1: Accident: Fourth indent: Injury to passengers Class 3: Land vehicles Class 7: Goods in transit Class 10: Motor vehicle liability 3. Marine and Transport Insurance Class 1: Accident: Fourth indent: Injury to passengers Class 4: Railway rolling stock Class 6: Marine and Transport Insurance Class 7: Goods in transit Class 12: Liability for ships (sea, lake and river and canal vessels) 4. Aviation Insurance Class 1: Accident: Fourth indent: Injury to passengers Class 5: Aircraft Class 7: Goods in transit Class 11: Aircraft liability 5. Insurance against fire and other damage to property Class 8:Fire and Natural forces Class 9: Other damage to property 6. Liability Insurance Class 10: Motor vehicle liability Class 11: Aircraft liability Class 12: Liability for ships (sea, lake and river and canal vessels) Class 13: General liability 7. Credit and Suretyship Insurance Class 14: Credit Class 15: Suretyship Annex II of the Directive: CLASSES OF LIFE INSURANCE : Annexure II of Directive 2009/138/EC (Solvency II) has classified life into the following classes: Page 6 of 38

7 Number and Class Description / Detail 1. Life Insurance (non-linked) 2. Marriage, birth 3. Investment Linked 4. Permanent Health Insurance a) Assurance o on survival to stipulated age only o on death only o on survival to stipulated or earlier death o with return of premiums b) Annuities c) Supplementary underwritten in addition to life, in particular, against personal injury including incapacity for employment, against death resulting from an accident and against disability resulting from an accident or sickness Insurance referred to in 1a) and 1b) above, which are linked to investment funds. Insurance providing specified benefits against risks of persons becoming incapacitated in consequence of sustaining injury as a result of an accident or of an accident of a specified class or of sickness or infirmity. 5. Tontines Whereby associations of subscribers are set up with a view to jointly capitalizing their contributions and subsequently distributing the assets thus accumulated among the survivors or among the beneficiaries of the deceased. 6. Capital redemption operations 7. Management of group pension funds Based on actuarial calculations whereby, in return for single or periodic payments agreed in advance, commitments of specific duration and amount are undertaken. Comprising the management of investments, and in particular the assets representing the reserves of bodies that effect payments on death or survival or in the event of discontinuance or curtailment of activity. 8. Collective Insurance Insurance where the assets and rights are isolated from other insured. 9. Social Insurance Operations relating to the length of human life which are prescribed by or provided for in social legislation, in so far as they are effected or managed by life undertakings at their own risk in accordance with the laws of a Member State. 4. MAPPING ANY PRINCIPLE (LEVEL 1) DIFFERENCES BETWEEN IAIS ICP & EU DIRECTIVE The IAIS ICP on licensing is a principle based standard with no guidance on the authorisation classes. At best, the associated guidance on the ICP indicates that the supervisors should at least distinguish between life and non-life. Page 7 of 38

8 Therefore the authorisation classes noted in Annex I and Annex II of the EU directive does not contradict the IAIS ICP on licensing in any way. 5. STANDARDS AND GUIDANCE 5.1 CEIOPS Consultation Papers and Quantitative Impact Studies (QIS) CEIOPS has issued CP 27 aimed at segmentation for the purpose of calculating technical provisions but not for the purpose of the authorisation of classes. Similarly the QIS5 specifications have included segmentation requirements with regards to the calculation of technical provisions, but do not address authorisation classes. For completeness, the QIS5 classes of business for calculating technical provisions are tabled below: Non-life Insurance: Contract Type 1. Non-life direct and proportional re 2. Non-life nonproportional re Class Medical expense Income protection Workers' compensation Motor vehicle liability Other motor Marine, aviation and transport Fire and other damage to property General liability Credit and suretyship Legal expenses Assistance Miscellaneous financial loss Non-proportional health re Non-proportional property re Non-proportional casualty re Non-proportional marine, aviation and transport re Page 8 of 38

9 Life Insurance: Contract Type 1. Life Insurance with profit participation 2. Index-linked and unit-linked 1. Death 2. Survival Class (Contract type and Main risk driver) 3. Disability / morbidity 4. Saving 5. Death 6. Survival 7. Disability / morbidity 8. Saving 3. Other life 9. Death 4. Accepted re 10. Survival 11. Disability / morbidity 12. Saving 13. Death 14. Survival 15. Disability / morbidity 16. Saving A 17th business class is dedicated to annuities stemming from non-life contracts. Page 9 of 38

10 5.2 The Australian Prudential Regulatory Authority (APRA) Life Insurance: The Life Insurance Act (Act No. 4 of 1995 as amended) of Australia prescribes the conditions for registration of life companies in Australia. These conditions do not classify business into different classes for the purpose of authorisation. The Act does distinguish between ordinary business and superannuation business. Ordinary business refers to all life business excluding superannuation business. Superannuation business refers to life policies: that are maintained for the purposes of a superannuation or retirement scheme and owned by the trustee under the scheme; or of a kind prescribed by the regulations for the purposes of this paragraph. The following is a list of the classes of life business used for reporting purposes by APRA: 1. Conventional participating 2. Participating Investment Account 3. Annuity with Longevity Risk 4. Individual Lump Sum Risk 5. Individual Disability Income Insurance 6. Group Lump Sum Risk 7. Group Disability Income Insurance 8. Non-par Investment Policy 9. Annuity without Longevity Risk 10. Other Details of each of the above classes are described in section 1 of Appendix A Non-life Insurance: The Insurance Act (Act No. 76 of 1973 as amended) of Australia prescribes the conditions for registration of general (non-life) companies in Australia. These conditions do not classify business into different classes for the purpose of authorisation. The following classes of non-life business are defined in APRA s General Insurance Prudential Standards for valuation and reporting purposes: 1. Fire and Industrial Special Risks (ISR) 2. House owners / Householders (H&H) 3. Compulsory Third Party Motor Vehicle (CTP) 4. Commercial Motor Vehicle 5. Domestic Motor Vehicle 6. Travel 7. Marine and Aviation 8. Mortgage 9. Consumer Credit (CCI) 10. Other Accident 11. Other 12. Public and Product Liability 13. Professional Indemnity (PI) 14. Employers' Liability (EL) Page 10 of 38

11 Details of each of the above classes are described in section 2 of Appendix A. 5.3 The Office of the Superintendent of Financial Institutions Canada (OSFI) The Canadian Insurance Companies Act (S.C. 1991, c. 47) specifies authorisation classes as set out in the list below. Note that Life Insurance is seen as a single class. 1. Accident and sickness 2. Aircraft 3. Automobile 4. Boiler and machinery 5. Credit 6. Credit protection 7. Fidelity 8. Hail 9. Legal Expenses 10. Liability 11. Life 12. Marine 13. Mortgage 14. Other approved products 15. Property 16. Surety 17. Title Details of each of the above classes are described in Appendix B. 6. ASSESSMENT OF AVAILABLE APPROACHES GIVEN THE SOUTH AFRICAN CONTEXT 6.1 The classes currently allowed within South Africa Life Insurance The classes of life for which the FSB may authorize a company in terms of the Long-term Insurance Act (Act No. 52 of 1998) are: 1. Assistance 2. Disability 3. Fund 4. Health 5. Life 6. Sinking fund Details of each of the above classes are described in section 1 of Appendix C. Page 11 of 38

12 6.1.2 Non-life Insurance In terms of the Short-term Insurance Act (Act No. 53 of 1998) the following short-term classes are allowed: 1. Accident and Health 2. Engineering 3. Guarantee 4. Liability 5. Miscellaneous 6. Motor 7. Property 8. Transportation Details of each of the above classes are described in section 2 of Appendix C. 6.2 Comparison of the different approaches with the prevailing legislative framework The classes above have been mapped to the Solvency II Directive classes taking into account the information provided within the descriptions, and are included in Appendix D. 6.3 Principles to consider when setting authorisation classes Risk-based approach: Having a risk-based authorisation classification will assist the FSB in assessing whether the insurer applying for a licence has the necessary expertise and resources to manage the risks it is taking on as part of its business, leading to a regime where policyholders are better protected. Relevance: Many jurisdictions have authorisation classes tailored to their particular environments. Examples include the ISR policies in Australia and the Title Insurance policies in Canada. When adopting any authorisation class used anywhere, the relevance of specific classes in the South African market needs to be considered. Third country equivalence: CEIOPS CP 78 on the technical criteria for assessing 3 rd country equivalence, with principle 2 dealing with authorisation requirements, is relevant. It indicates no prescription on the authorisation classes but places emphasis on the authorisation process. Practical consequences: Although the practical consequences of a proposed set of authorisation classes should not be the main focus when deciding on such a proposal, it should nevertheless be considered. When assessing international practice regarding authorisation classes it is therefore important to consider the local relevance, and the transition costs and risks. Page 12 of 38

13 6.4 Discussion of inherent advantages and disadvantages of various approaches The following possible different approaches exist for setting authorisation classes under the SAM regime: Retain or adapt existing FSB authorisation classes; Develop new authorisation classes; Adopt APRA / OSFI authorisation classes (perhaps with modification); Adopt Solvency II directive authorisation classes (perhaps with modification) Life Retain or adapt existing: The key advantage of maintaining the current authorisation classes are the practical implications. However, the aim of the authorisation classes under SAM would be to enhance the ability of the FSB to perform risk-based supervision. The authorisation classes should therefore reflect the underlying risk characteristics. The current authorisation classes, however, include smaller classes such as Assistance business, which are really a subset of a larger class ( Life business ). The option to retain the existing authorisation classes is therefore not recommended. The recommended approach (see section 7) is based on the Solvency II classes, but is also fairly similar to the current authorisation classes in South Africa. Develop new authorisation classes: Developing a new set of authorisation classes is akin to reinventing the wheel. Instead the option to adapt other authorisation classes seems more sensible. This option is therefore not recommended. Adopt APRA / OSFI authorisation classes (perhaps with modification): OSFI includes Life Insurance as a single class without further segmentation. The Technical Provisions Task Group is however of the opinion that there should be at least a small number of different authorisation classes, in order to be able to license companies with limited resources to operate in less complex and capital intensive classes. Using the OSFI guidance as a base is therefore not recommended. The APRA approach on the other hand is more granular than Solvency II, in that it separates different contract types in addition to different risk classes. It is the view of the Technical Provisions Task Group that the authorisation classes should reflect the main risk drivers only and not be overly granular. For this reason and because of the stated goal to develop SAM to meet Solvency II s third country equivalence requirements, the option to adapt APRA authorisation classes is seen as inferior to the option of adapting the Solvency II directive authorisation classes. Adopt Solvency II directive authorisation classes (with modification): Adopting Solvency II directive requirements for the authorisation classes with some adjustments has the advantage of making future comparisons easier when assessing third Page 13 of 38

14 country equivalence. The Solvency II requirements are also based on broad risk categories, which is in line with the views of the Technical Provisions Task Group. This option is therefore recommended with some adjustments, mainly relating to classes that are not prevalent in South Africa Non-life Retain or adapt existing: The key advantage of maintaining the current authorisation classes are the practical implications. Apart from industry players being familiar with these, licenses are already issued in terms of these classes, policies are structured into these classes and systems and processes in place are already sculpted around these classes. As the local authorisation classes are not very granular, it is possible for authorisation in one class to correspond to authorisation in multiple classes under the Solvency II directive authorisation classes. For example, being authorised locally for liability could potentially correspond to authorisation in classes 10, 11, 12 and 13 under Solvency II. Adapting the existing authorisation classes should be aimed at addressing the granularity and strictness of authorisation that is currently lacking. In the long-run, choosing to adopt stricter and more granular authorisation classes now should stand us in good stead once a third country equivalence assessment is undertaken on South Africa. Any expansion in the granularity of the current authorisation requirements will be a move towards the Solvency II directive requirements and improved risk management and policyholder protection in any event. The option to retain or adapt the existing authorisation classes is therefore not recommended. Develop new authorisation classes: Developing a new set of authorisation classes is akin to reinventing the wheel. Instead the option to adapt other authorisation classes seems more sensible. This option is therefore not recommended. Adopt APRA / OSFI authorisation classes (perhaps with modification): Both the OSFI and APRA authorisation classes are more granular than the current local authorisation classes. It is clear that both OSFI and APRA have adapted their authorisation classes to their local environments. Examples include the ISR policies in APRA and the Title policies in OSFI. Neither of OSFI or APRA should be used as is for local authorisation classes without some adaptation. It is useful to note that the OSFI and APRA authorisation classes can be considered subsets of the more granular Solvency II directive requirements for authorisation classes. Because of the stated goal to develop SAM to meet third country equivalence requirements, the option to adapt OSFI or APRA authorisation classes is seen as inferior to the option of adapting the Solvency II directive authorisation classes. This option is therefore not recommended. Page 14 of 38

15 Adopt Solvency II directive authorisation classes: Adopting Solvency II directive requirements allows for assessment and granting of licences to insurers that have the knowledge and capacity to underwrite potentially volatile classes of business, for example Marine liability. Use of the granular Solvency II directive authorisation classes could potentially lead to similar segmentation between reporting of technical provisions and capital requirements under the standard model. This has a number of advantages around the exchanging of information between regulators, for local insurers reporting to an international parent subject to Solvency II and leveraging results from QIS exercises already done in the EU. As noted in a number of instances in this discussion paper, the practical consequences of expanding the current authorisation classes are not insignificant. Considering the options available and the stated goal of third country equivalence as well as improved risk management and policyholder protection, this option is recommended but with minor adjustments as reflected under the final recommendation. 7. RECOMMENDATION Sections 7.1 and 7.2 below outline the recommended authorisation classes for SAM as adapted 1 from the Solvency II directive. 7.1 Life 2 : Life will be defined as follows: Life : means any arrangement under which a person against direct or indirect, or partially or fully subsidised, payment of any consideration accepts a specified risk from another person by undertaking to (i) pay that other person or that person s estate or another identified person a specified amount or specified equal or unequal periodical amounts (annuity) to satisfy that person or that person s estate or another identified person for a non-actual financial loss, on the happening of a specified uncertain future event relating to the life, health, disability or death of that person in which that person or that person s estate or another identified person at the start of the arrangement and at any time thereafter has an insurable interest 3 in respect of the non-occurrence of that event; and/or (ii) provide that other person or that person s estate or another identified person a specified amount or specified equal or unequal periodical amounts (annuity), on or from a fixed or determinable future date (which date may not be less than 5 years from the start date of the arrangement unless otherwise prescribed by the Registrar), irrespective of amounts being linked to assets and investments identified in the arrangement; guaranteed at the start of the arrangement; or 1 Deletions from the Solvency II directive are formatted as strikethrough and additions are underlined. 2 Definition still subject to consultation. 3 To be defined. Page 15 of 38

16 determined by reference to the value of particular assets or categories of assets identified in the arrangement; and includes a renewal or variation of that arrangement. The following table shows the recommended authorisation classes under SAM: CLASS SUB-CLASS DESCRIPTION ALLOWED RIDER BENEFITS 1) Individual Life Risk 2) Group 4 Life Risk a) Life annuities Benefits are provided in the form of specified equal or unequal periodic amounts (annuity) for a term dependent solely or partly on the life of a person b) Life risk (excluding annuities) Benefits are provided in the form of a specified amount (other than an annuity) on death on the happening of an event or contingency dependant on human life a) Life annuities Same as for Individual Life Risk (subclass: Annuities) Insurance against personal injury Accidental death Birth Retrenchment Same as for Individual Life Risk b) Life risk (excluding annuities) Same as for Individual Life Risk (subclass: Life risk excluding annuities) 3) Individual Disability or Health Risk a) Annuities Benefits are provided in the form of specified equal or unequal periodic amounts (annuity) on the occupational or functional ability of the mind or body of a person becoming temporarily or permanently impaired on the health of the mind or body of a person becoming temporarily or permanently impaired b) Lump sum Benefits are provided in the form of a specified amount (other than an annuity) on the happening of the events referred to above 4 For purposes of this class group means (a) an autonomous association of persons united voluntarily to meet their common or shared economic and social needs and aspirations which association is democratically-controlled; or (b) persons of similar occupation or profession or who are employed by a common employer. Page 16 of 38

17 CLASS SUB-CLASS DESCRIPTION ALLOWED RIDER BENEFITS 4) Group 5 Disability or Health Risk a) Annuities Same as for Individual Disability or Health Risk (sub-class: Annuities) b) Lump sum Same as for Individual Disability or Health Risk (sub-class: Lump sum) 5) Individual 6 Investment (other than linked) a) Partially or fully guaranteed b) Discretionary participation features 7 c) Marketrelated Benefits are provided in the form of a specified amount (lump sum) or specified equal or unequal periodic amounts (annuity) on the happening of the events referred to under Individual Life Risk; or on a fixed or determinable future date Premium waivers on death or disability 6) Fund 8 Investment (other than linked) a) Partially or fully guaranteed b) Discretionary participation features 9 c) Marketrelated Benefits are provided for the purpose of funding in whole or in part the obligation of a group to provide investment benefits to its members in terms of its rules, other than such a contract relating exclusively to a particular member of the fund or to the surviving spouse, children, dependants or nominees of a particular member of the fund. 7) Linked Investment Benefits provided are not guaranteed and are determined solely by reference to the value of particular specified assets or categories of assets actually held by or on behalf of the insurer for that purposes. 8) Nonproportional re Benefits are provided as per the accepted treaty obligations. 5 Has the same meaning as set out in footnote 4. 6 For purposes of this class individual includes a legal person. 7 A contractual right to receive, as a supplement to guaranteed benefits, additional benefits: (a) that are likely to be a significant portion of the total contractual payments; (b) whose amount or timing is contractually at the discretion of the issuer; and (c) that are contractually based on: (i) the performance of a specified pool of contracts or a specified type of contract; (ii) realised and/or unrealised investment returns on a specified pool of assets held by the issuer; or (iii) the profit or loss of the company, fund or other entity that issues the contract. 8 For purposes of this class fund means a friendly society as defined in section 1 of the Friendly Societies Act, 1956; a pension fund organization as defined in section 1 of the Pension Funds Act, 1956; a medical scheme as defined in section 1 of the Medical Schemes Act, 1998; and a group of persons of similar occupation or profession or who are employed by a common employer. 9 See footnote 7 Page 17 of 38

18 Comparing the proposed authorisation classes to the current regime, the following should be noted: Proportional re may be written under the same authorisation classes as apply to direct. Re(insurers) wanting to accept non-proportional re will have to be specifically authorised for the non-proportional re class, as well as the classes of business from which the non-proportional re originates. Where premium waivers (or other riders) are offered, the insurer does not need to be authorised for the class of business relating to the event that triggers the waiver. For example, if a premium waiver is triggered on a disability event, the insurer does not need to be authorised for Disability or Health Risk. Assistance business will be included under the Life Risk classes. Much of the business written under the current assistance business class is anticipated, in future, to be written under a dedicated micro licence. Sinking fund business will be included under the Investment classes. Where policies are written that provide benefits that are linked to the value of investment funds, but also cover life risks, the insurer will need to be authorised for both Investment and Life Risk classes. One example of this is Universal Life 10 contracts. Another, less obvious, example is participating business where the life risk is shared amongst the participating policyholders. Although the insurer in this case does not bear (all) the life risk directly, there is a burn-through possibility where poor life underwriting experience within the participating policyholders could result in the need for shareholders of the insurer to inject capital. Similarly, the insurer may need to be authorised for a Disability or Health Risk class if the contract includes disability risk as well. Pure (i.e. no risk benefits) Retirement Annuities need to be authorised under the Investment class. Retirement Annuities with life cover will also require authorisation under the Life Risk classes. The Disability or Health Risk classes do not include Medical Aid business, which is regulated under the Council of Medical Schemes. 7.2 Non-life Insurance: Non-life will be defined as follows: Non-life - means any arrangement under which a person against direct or indirect, or partially or fully subsidised, payment of any consideration, accepts a risk from another person; (a) by undertaking to - (i) restore that other person or that person s estate or another identified person to the actual financial position (or a part thereof) that person would have been in if not for the happening of a specific uncertain future event; or (ii) make good the actual financial loss or liability for actual financial loss (or a part thereof) of that other person or that person s estate or another identified person; (b) on the happening of a specific uncertain future event, excluding events relating to disability, life or death, in which that other person or that person s estate or another 10 The nature of universal life policies is that at inception they are more akin to life products, but towards maturity more like savings products. Page 18 of 38

19 identified person at the start of the arrangement and at any time thereafter has an insurable interest 11 in respect of the non-occurrence of that event; and includes a renewal or variation of that arrangement. The following table shows the recommended authorisation classes under SAM: CLASS SUB-CLASSES DESCRIPTION ALLOWED RIDER BENEFITS 1. Accident and Health Policy benefits cover damage or loss arising out of an accident or illness limited to contingency expenses associated with an accident or illness; and excluding actual costs or expenses of a relevant health service as section 1 of the Medical Schemes Act 2. Motor a) Personal b) Commercial 3. Aircraft 4. Marine 5. Rail 6. Transport Policy benefits cover damage or loss arising out of the possession, use or ownership of motor vehicles and other vehicles operating on land (excluding railway rolling stock), but excludes warranty business Policy benefits cover damage or loss arising out of the possession, use or ownership of aircraft. Policy benefits cover damage or loss arising out of the possession, use or ownership of river, canal, lake and sea vessels. Policy benefits cover damage or loss arising out of the possession, use or ownership of railway rolling stock. Policy benefits cover damage to or loss of goods in transit or baggage. Assistance for persons who get into difficulties while travelling, while away and at their home/habitual residence 11 To be defined. Page 19 of 38

20 CLASS SUB-CLASSES DESCRIPTION ALLOWED RIDER BENEFITS 7. Agriculture 8. Engineering 9. Property a) Personal b) Commercial 10. Liability a) Motor b) Aircraft c) Marine d) Rail e) Transport f) Engineering g) Other Policy benefits cover damage or loss to crop and other agricultural activities due to fire, explosion, natural forces including storm, hail or frost, nuclear energy and land subsidence. Policy benefits cover damage to or loss arising out of the possession, use or ownership of machinery or equipment, the erection of buildings, or other structure of the undertaking of other works, or the installation of machinery or equipment. Property benefits cover damage to or loss arising out of the possession, use or ownership of property (other than classes 2 to 8 above) due to fire, explosion, natural forces including storm, hail or frost, nuclear energy, land subsidence and any event such as theft. Commercial lines also includes business interruption cover such as unforeseen trading expenses and loss of rent or revenue. Policy benefits cover third party liability arising out of: bodily injury to, or the disability or death of, a person, including an employee; the loss of, or damage to, property; or if the policy includes the described in the first bullet, against expenses arising out of bodily injury to a person other than the insured or a member of the insured s family, whether or not liability exists. Page 20 of 38

21 CLASS SUB-CLASSES DESCRIPTION ALLOWED RIDER BENEFITS 11. Trade credit, suretyship and guarantees 12. Consumer credit 13. Legal 14. Travel Policy benefits cover loss arising out of insolvency, export credit, agricultural credit, direct and indirect guarantees (failure of a person to discharge an obligation under a contract) and suretyship. Policy benefits cover loss arising out of consumer insolvency and default on instalment credit or mortgages Policy benefits cover legal expenses and costs of litigation Policy benefits cover damage or loss arising out of cancellation, interruption, loss of property, (including baggage), or other unforeseen events before, while and after travelling. Payment of outstanding balance to credit provider on retrenchment. Premium waivers on death or disability. Fixed amount benefit on accidental death / disability 15. Miscellaneous Such as: Warranties Pet 16. Nonproportional re Obligations relating to accepted non-proportional treaty and facultative re Comparing the proposed authorisation classes to the current regime, the following should be noted: Proportional re may be written under the same authorisation classes as apply to direct. Re(insurers) wanting to accept non-proportional re will have to be specifically authorised for the non-proportional re class, as well as the classes of business from which the non-proportional re originates. Benefits listed in the rider benefits column may be written (without specific/additional authorisation) if the insurer is authorised for the corresponding class of business. The Non-Life Accident and Health class will be distinct from the Life Disability and Health class as the nature of the benefits that can be written under these authorisation classes will differ. Page 21 of 38

22 Personal Lines refers to any type of that indemnifies non-business type accounts where the products are designed for and bought by individuals in their private and personal capacity. Commercial Lines refers to any type of that indemnifies any form of businesses, professionals or commercial establishments. Travel may not include fixed benefits on the death of the insured. (However, repatriation of remains and related costs are permitted.) Similarly a motor policy may not include fixed benefits on death. To offer a comprehensive motor policy that covers both damage to property and liability cover, an insurer will have to be authorised in both the Motor and Liability (Motor subclass) classes of business. The following table maps the current Short-term Insurance Act authorisation classes to these new proposed authorisation classes. Current Short-term Insurance Act Accident and Health Engineering Guarantee Liability Proposed Accident and Health Engineering Trade credit, suretyship and guarantee Liability (with various sub-classes) Legal expenses Miscellaneous Travel Consumer credit Miscellaneous Motor Property Motor Property Agriculture Aircraft Transportation Marine Rail Page 22 of 38

23 Current Short-term Insurance Act Proposed Transportation Page 23 of 38

24 APRA Non-life Insurance - Classes of Business Detail APPENDIX A a. Life Insurance Class 1. Conventional participating Description / Detail Includes Whole of Life policies and endowment policies 2. Participating Investment Account 3. Annuity with Longevity Risk 4. Individual Lump Sum Risk 5. Individual Disability Income Insurance 6. Group Lump Sum Risk 7. Group Disability Income Insurance 8. Non-par Investment Policy 9. Annuity without Longevity Risk Exclude non-participating investment account policies Annuities providing periodic payments that are dependent on the continuance of human life Lump sum risk policies issued on an individual (retail) basis. Includes non-participating conventional policies Disability Income Insurance policies issued to individuals Lump sum risk policies issued on a group (wholesale) basis Disability Income Insurance policies issued on a group basis Include non-participating investment account and investment linked policies Annuities providing periodic payments that are NOT dependent on the continuance of human life 10. Other Include all other products not specifically categorised above Page 24 of 38

25 b. Non-life Insurance Class 1. Fire and Industrial Special Risks (ISR) 2. House owners / Householders (H&H) 3. Compulsory Third Party Motor Vehicle (CTP) 4. Commercial Motor Vehicle 5. Domestic Motor Vehicle Description / Detail Fire: Includes all policies normally classified as 'Fire' and includes: sprinkler leakage; subsidence; windstorm; hailstone; crop; arson; and loss of profits and any extraneous risk normally covered under fire policies, e.g. flood. ISR: Standard policy wordings exist for this type of policy. All policies which contain such standard wordings or where the wording is substantially similar are to be classified as ISR. This class covers the common H & H policies inclusive of: Contents; Personal property; Arson; and Burglary. Public liability normally attached to these policies. Motor vehicle (including third party property damage) other than covering vehicles defined below under Domestic Motor Vehicle. It includes long and medium haul trucks, cranes and special vehicles and policies covering fleets. Motor vehicle (including third party property damage) covering private use motor vehicles including utilities and lorries, motor cycles, private caravans, box and boat trailers and other vehicles not normally covered by business or commercial policies. 6. Travel Insurance against losses associated with travel including loss of baggage and personal effects, losses on flight cancellations and overseas medical costs. 7. Marine and Aviation Includes Marine Hull (including pleasure craft), Marine Cargo (including sea and inland transit ) and Aviation which includes aircraft hull and aircraft liability. 8. Mortgage Insurance against losses arising from the failure of debtors to meet financial obligations to creditors or under which payment of debts is guaranteed. It includes lease guarantee. Page 25 of 38

26 Class 9. Consumer Credit (CCI) Description / Detail Insurance to protect a consumer's ability to meet the loan repayments on personal loans and credit card finance in the event of death or loss of income due to injury, illness or unemployment. 10. Other Accident Includes the following types of : Miscellaneous accident (involving cash in transit, theft, loss of money); All risks (baggage, sporting equipment, guns); Engineering when not part of ISR or Fire policy; Plate glass when not part of packaged policy (e.g. house owners / householders) 11. Other All other business not specifically mentioned elsewhere. It includes, for example: All guarantees (e.g. fidelity Guarantee) Trade Credit; Extended Warranty; Legal Expense; Kidnap and Ransom; and Contingency. 12. Public and Product Liability 13. Professional Indemnity (PI) 14. Employers' Liability (EL) Public Liability covers legal liability to the public in respect of bodily injury or property damage arising out of the operation of the insured's business. Product Liability includes policies that provide for compensation for loss and or injury caused by, or as a result of, the use of goods and also environmental cleanup caused by pollution spills where not covered by Fire and ISR policies. Includes Directors' and Officers' liability. Includes: Workers' compensation; Seamen's compensation; and Domestic workers compensation. Page 26 of 38

27 OSFI Classes of Business Detail APPENDIX B Class Description / Detail 1. Accident and sickness accident and sickness means (a) against loss resulting from bodily injury to, or the death of, a person caused by an accident; (b) under which an insurer undertakes to pay a sum or sums of money in the event of bodily injury to, or the death of, a person caused by an accident; (c) against loss resulting from the sickness or disability of a person not caused by an accident, but excludes loss resulting from the death of the person as a consequence of sickness; (d) under which an insurer undertakes to pay a sum or sums of money in the event of the sickness or disability of a person not caused by an accident; or (e) under which an insurer undertakes to pay a sum of money in respect of the health care including dental care and preventative care of a person. 2. Aircraft aircraft means against (a) liability arising out of bodily injury to, or the death of, a person, or the loss of, or damage to, property, in each case caused by an aircraft or the use of an aircraft; or (b) the loss of, the loss of use of, or damage to, an aircraft. 3. Automobile automobile means (a) against liability arising out of bodily injury to, or the death of, a person, or the loss of, or damage to, property, in each case caused by an automobile or the use or operation of an automobile; (b) against the loss of, the loss of use of, or damage to, an automobile; or (c) that falls within paragraph (a) or (b) of the class of accident and sickness, if the accident is caused by an automobile or the use or operation of an automobile, whether or not liability exists in respect of the accident, and the policy includes against liability arising out of bodily injury to, or the death of, a person caused by an automobile or the use or operation of an automobile. 4. Boiler and machinery boiler and machinery means (a) against liability arising out of bodily injury to, or the death of, a person, or the loss of, or damage to, property, or against the loss of, or damage to, property, in each case caused by the explosion or rupture of, or accident to, pressure vessels of any kind or pipes, engines and machinery connected to or operated by those pressure vessels; or (b) against liability arising out of bodily injury to, or the death of, a person, or the loss of, or damage to, property, or against the loss of, or damage to, property, in each case caused by a breakdown of machinery. Page 27 of 38

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