SECOND SCHEDULE
FORM1
2002
(section8)
FOR LICENCE TO CARRY ON INTERNATIONAL
AND TAKAFUL BUSINESS
1.
State the name of the applicant.
.
.
2.
State the full address of -
(a)
the registered office of the applicant in Brunei Darussalam.
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(b)
the principal office of the applicant in Brunei Darussalam.
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.
(e)
the registered office and the principal business address abroad (in case of company incorporated abroad).
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3.
State date and place of incorporation.
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.
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837
FORM 1 - {continued}
4.
State the basic characteristics of the applicant by ticking the appropriate box under Ii) and (ii).
(i)
Company organised by shares
Mutual Company
International
Business Company
Foreign International
Company
Domestic Brunei Darussalam
Company
Dedicated Cell Company
Other (please state)
(ii)
5.
Ii)
State the amount of the issued and paid-up capital at present, and the date paid in.
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(ii)
Has all the paid-up capital been subscribed in cash? If not, give or attach full details.
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6.
Will the applicant be writing unrelated risks i.e. risks of persons who, apart from the insurance contract itself, have no connection or association with the applicant -
Ii)
as a direct insurer.
,
.
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838
FORM1 - (continued!
7.
If 6(i) and 6(H) are both answered in the negative, explain here or by attachment the nature at the connection or association that exists between the applicant and those persons whose risk the applicant intends writing either directly or as are-insurer.
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8.
State the category of insurance business which the applicant proposes to write (Le. general business only, long-term business only or both general and long-term business).
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9.
State the class or classes (e.g. property, casualty, marine, aviation) of general insurance business which the applicant intends to write and state estimated gross and net premium by class of business for the first 2 years of operation.
If it is intended to write products liability risks or professional liability risks or both, state estimated gross and net premium in respect of each separately.
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10.
State when the applicant intends to commence writing the above class or classes of business.
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839
FORM1- {continued}
11.
In respect of general business, give estimated income for each of the first 2
years, on as realistic a basis as possible, using the following format -
Gross premiums written
Less re-insurance premiums ceded
Net premiums written
Less increase (plus decrease) in unearned premiums
Net premiums earned
Plus investment income
Plus other insurance income
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..."
..
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SUB-TOTAL
Net losses and loss expenses incurred
Reserve for claims incurred but not reported
(if applicable)
Commissions and brokerage incurred
General and administrative expenses
Personnel costs
Other expenses
Income taxes (if applicable)
SUB-TOTAL
Estimated net income for year
...........
N.B.l
The Order provides for solvency margins in accordance with the formulae therein.
Please provide as an appendix estimated margins and the basis of calculation.
N.B.2
The Authority will require to be satisfied as to the assets representing a minimum liquidity ratio for general business.
As a general guide, the value of the relevant assets of an insurer carrying on general business shall be not less than 75 per cent of the amount of its relevant liabilities.
12.
In respect of long-term insurance business, state as an appendix in the format below, on as realistic a basis as possible, the estimated volume of business to be transacted during each of the first 2 years, giving for each type of policy the number of contracts the total sums assured or amounts of annuity per annum, and the annual or single premiums.
Figures should be given both gross and net of re-insurance and should relate to world-wide business. A final table should summarise the total premium income.
840
FORM 1 -
(continued)
Note: Same format for year 2 as for year 1.
13.
Give particulars of any business other than insurance business which the applicant proposes to carry on.
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14.
Give name of and limits carried by primary carrier, if any.
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15.
State the maximum net retention by class of business, for anyone risk per occurrence.
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16.
State layer of retention
(primary or excess of
) by class of business.
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17.
State whether annual aggregate (i.e. stop loss) re-insurance has been or will be arranged.
If so, state maximum annual aggregate net losses to be retained by class of business.
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841
ORDINARY LONG TERM BUSINESS PLAN
Type of policy
Year 1
No. of contracts
Total Premium Income
Total sums insured or
Gross
Net of re-amounts or insurance annuity per annum
FORM1 - {continued}
18.
Proposed re-insurance arrangements set forth in the format below in respect of each class of business, including in particular the nature and extent of the existing or names of, and, where they have been rated by recognised rating organisations, the most recent ratings assigned to, the insurance companies or associations of underwriters which will re-insure each class at the applicant's business and the amount which will be reinsured by each. If more than 10 companies will re-insure a class business, the names of only the principal re-insurers need be stated.
19.
State the full name and address of the following who have accepted their appointment, attaching formal evidence of acceptance of appointment duly signed -
(i)
Principal representative
(must be resident in Brunei Darussalam).
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(ii)
Insurance manager (if applicant has one).
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(iii)
Approved auditor.
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(iv)
(where required) Loss reserve specialist.
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842
Name
Rating
Class of insurance
Amount re-insured
FORM1- {continued}
20.
For applicant carrying on long-term business, state the full name and address of the approved actuary, attaching formal evidence of acceptance of appointment duly signed.
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21.
Indicate by ticking the appropriate boxes which of the following are to be kept in Brunei Darussalam
-
(i)
general ledger
(ii)
general journal
(iii)
subsidiary ledgers referred to in the general ledger
(iv)
cash books for receipts and disbursements
(v)
premium registers
(vi)
loss registers
(vii)
re-insurance reports
(viii)
daily reports of claim files
(ix)
copies of policies
(x)
copies of re-insurance treaties and agreements 22.
Will those of the foregoing business records which will be kept in Brunei
Darussalam enable the directors to ascertain within a reasonable period and with reasonable accuracy the applicant's position at the end of each 3 month period?
Please answer "Yes" or "No". If "No", please explain.
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23.
Give the addresses where such records are to be kept in Brunei Darussalam.
(i)
(ii)
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(iii)
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24.
State the date on which the applicant's financial year will end.
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843
FORM1-
(continued)
25.
If the answer to question 6(i) was in the affirmative -
(a)
state the method or methods by which the business will be obtained
(e.g. by the applicant's own employees, and by brokers or agents).
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(b)
state the way in which settlement of claims will be handled
(e.g. by the company, by outside loss adjusters or assessors, or by other agents with authority to settle claims).
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(c)
give details of any connection or association
(including in particular a connection of a financial kind) which exists between any of the brokers, agents, loss adjusters and assessors referred to in (a) and (b) above, and any director of the applicant, any director it is proposed at present to appoint, any person having a majority share holding in the applicant, or any other person on whose directions the directors of the applicant or any of them act or will act.
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(d)
give details of any loans which the applicant has made, or proposes to make, to any officer of the applicant or his spouse or to any partnership in which an officer of the applicant or his spouse has an interest.
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(e)
give details of any loans or investments, actual or proposed, to or in any subsidiary or associated company or any company at any general meeting of which any officer to the applicant or any person controlling the applicant, or their respective spouses, is entitled to exercise, or control the exercise of, one-third or more of the voting power.
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844
FORM1 -
(continued)
We certify that to the best of our knowledge and belief all of the information given in this application is true and correct and that all estimates given are true estimates based upon facts which have been carefully considered and assessed.
(Signed)
."""""""""""(Di;~~~'~;)"""""""""""
date
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(Name) ...............................................................................................................
(Signed) """"""""(R~~id~~~'di~'~~~~;j""""""'"
date
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(Name) ...............................................................................................................
(Signed)
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(Principal representative)
date
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(Name) ...............................................................................................................
Note:
Your attention is drawn to the provisions of sections 64 and 65 of the
Order relating to offences in relation to false, deceptive and misleading statements.
845
FORM 2
(section 11)
FOR LICENCE TO CARRY ON BUSINESS AS INTERNATIONAL
INSURANCE MANAGER, INTERNATIONAL
MANAGER OR
INSURANCE BROKER
*Application being completed as
(tick appropriate box)
International
Insurance
Manager
International
Underwriting
Manager
International
Insurance
Broker
International
Insurance
Manager
(incorporated)
International
Underwriting
Manager
(incorporated)
International
Insurance
Broker
(incorporated)
1.
Name.
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2.
Address.
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3.
Place established and number of years established under present name.
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If established under other name or names, give information and date or expiration of such business.
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4.
Address of head or registered office.
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846
FORM2 -fcontinued)
5.
fa)
Name and address of advocate and solicitor in Brunei Darussalam.
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fbJ
Name and address of auditor in Brunei Darussalam.
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6.
Name of principal banker in Brunei Darussalam.
.
.
7.
Copies of last accounts
(including balance sheet)
prepared or such documentary evidence as will show the financial capacity of the applicant
(e.g. a public accountant's certificate as to the applicant's net worth).
8.
If insurance manager or insurance broker, state whether or not you have professional indemnity cover. If "Yes", give name of insurer or insurers.
.
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9.
Particulars of any business other than insurance business carried on at present.
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10.
Details, if any, of any unit-linked insurance business to be carried on under the Order.
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847
FORM2 -
(continued)
11.
If agent for non-resident insurance undertaking attach copy of agency agreement or such other documentary evidence as will show your authority to act on behalf of insurer or insurers for which you act.
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12.
Details of experience in insurance business.
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13.
Give details of membership or proposed membership of any professional body or trade association.
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14.
Attach a complete list of all person
(e.g. brokers, sub-agents and salesmen)
through whom the applicant carries on business in Brunei Darussalam.
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15.
If international insurance manager or international underwriting manager, attach a list of all international insurers for which you provide services (see section 27 of the Order).
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16.
Attach evidence of intention to comply with
Brunei
Darussalam
Immigration and Labour legislation (where applicable).
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848
FORM2 -
(continued)
I/We certify that to the best of my/our knowledge and belief all of the information given in this application is true and correct and that all estimates given are true estimates based upon facts which have been carefully considered and assessed.
Name(s)
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Signature(s)
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"..."""""'...'."."."..'.
"."..'...'.".",.",.",
".",.".."..,..,
"...'."."""
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Date
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Note:
Your attention is drawn to the provisions of sections 64 and 65 of the
Order relating to offences in relation to false, deceptive and misleading statements.
849
FORM3
(section8)
Company No.:
LICENCE TO CONDUCT INTERNATIONAL
INSURANCE BUSINESS
This is to certify that
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incorporated under ........................................................................................
has been issued with a licence to conduct the following class/classes of international insurance business,
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subject to the provisions of the Order and to the conditions attached to the licence at the date hereof and as the same may be varied from time to time.
Given under my hand this day of 200 ........
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Authority 850
FORM4
(section 11)
Company No.:
LICENCE TO CONDUCT
BROKING/MANAGlNGIUNDERWRITING
This is to certify that
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"""""""""""""""""""""""""""...........
incorporated under
........................................................................................
has been issued with an
International
Insurance
Broking/Managing/
Underwriting licence to conduct international insurance business subject to the provisions of the Order and to the conditions attached to the licence at the date hereof and as the same may be varied from time to time.
Given under my hand this day of
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200 ........
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Authority 851
FORM5
2002
(section 18)
NOTIFICATION
BY LICENSEE
OF CHANGE OR PROPOSED
CHANGE IN PARTICULARS
Notice is hereby given under section 18 of the International
Insurance and
Takaful Order, 2002 of a change/proposed change in particulars, and the following particulars are furnished in respect thereof -
I
(name), a director of
(name of licensee) hereby give notice that following change(s)
of particulars have occurred/been proposed in respect of the following -
Dated this
, day of
,
200 ...........
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Director
If insufficient space, please include annexure.
Lodged in the office of the Authority in Brunei Darussalam by -
For Authority's use
Name:
Address:
Telephone
No.:
Fax No.:
Checked by:
Made this 24th. day of Rabiulawal,
1423 Hijriah corresponding to the 6th.
day of June, 2002.
DATO PADUKA AWANG HAJI ABDUL RAHMAN BIN HAJI IBRAHIM
Permanent
Secretary,
Ministry of Finance,
Brunei Darussalam.