Long Term Insurance Act, 1998 (Act No. 52 of 1998)RegulationsRegulations under the Long-term Insurance Act, 1998Part 6 : Binder Agreements6.1 Definitions and interpretations |
In this Part 6, unless the context indicates otherwise—
"administrative FSP"
has the meaning assigned to it in the Codes of Conduct for Administrative and Discretionary FSPs published in Board Notice No. 79 of 8 August 2003, and amended from time to time, under the FAIs Act;
[Definition substituted by regulation 7(a) of Notice No. 1437 of 2017]
"associate"
| (a) | has the meaning assigned to it in the General Code of Conduct; and |
| (b) | in addition to paragraph (a), includes, in respect of a juristic person,— |
| (i) | another juristic person that has a significant owner or member of its governing body that is also a significant owner or member of the governing body of the first mentioned juristic person; and |
| (ii) | another juristic person that has a person as a significant owner or member of its governing body who is an associate (within the meaning of paragraph (a)) of a significant owner or member of the governing body of the first mentioned juristic person; |
[Definition substituted by regulation 7(b) of Notice No. 1437 of 2017]
"binder agreement"
means an agreement contemplated in section 49A of the Act'
[Definition substituted by regulation 7(c) of Notice No. 1437 of 2017]
means any of the functions contemplated in section 49A(1)(a) to (e) of the Act;
[Definition inserted by regulation 7(d) of Notice No. 1437 of 2017]
"binder holder"
means a person with whom an insurer has concluded a binder agreement;
"enter into"
means any act that results in an insurer becoming liable to provide policy benefits under a policy where the person performing the act may do so without the insurer becoming aware of the act until after the act has been performed;
means the Financial Advisory and Intermediary Services Act, 2002 (Act No. 37 of 2002);
[Definition inserted by regulation 7(e) of Notice No. 1437 of 2017]
in respect of a—
(a) registered insurer, means one or more—
(i) life policies where the policy benefits relate only to services or costs associated with funerals; or
(ii) assistance policies;
(b) licensed insurer, means one or more policies underwritten—
(i) under the Funeral class of life insurance business as set out in Table 1 of Schedule 2 of the Insurance Act; or;
(ii) by a microinsurer as defined in section 1 of the Insurance Act;
[Definition substituted by regulation 8(a) of Notice No. 1015, GG 41942, dated 28 September 2018]
means the General Code of Conduct for Authorised Financial Service Providers and Representatives as published in Board Notice No. 80 of 2003, and amended from time to time, under section 15 of the FAIS Act;
[Definition inserted by regulation 7(g) of Notice No. 1437 of 2017]
has the meaning assigned to it in section 1 of the Financial Sector Regulation Act, 2017 (Act No. 9 of 2017);
[Definition substituted by regulation 8(b) of Notice No. 1015, GG 41942, dated 28 September 2018]
"independent intermediary"
has the meaning assigned to it in regulation 3.1;
"insurer"
[Definition deleted by regulation 7(i) of Notice No. 1437 of 2017]
means policy and policyholder data is in a format that is readily recognisable and capable of meaningfully utilised immediately by the core insurance systems and application of the insurer;
[Definition inserted by regulation 7(j) of Notice No. 1437 of 2017]
has the meaning assigned to in section 1 of the Companies Act;
[Definition inserted by regulation 7(k) of Notice No. 1437 of 2017]
"mandated intermediary"
means an independent intermediary that holds a written mandate from a potential policyholder or policyholder that authorises that intermediary, without having to obtain the prior approval of that potential policyholder or policyholder, to perform any act, including termination, in relation to a policy, that legally binds that potential policyholder or policyholder, other than an act directed only at changing the underlying investment portfolio of a policy;
"non-mandated intermediary"
means a representative or an independent intermediary, other than a mandated intermediary or an underwriting manager;
"policy"
means a long-term policy other than a reinsurance policy;
[Definition substituted by regulation 7(l) of Notice No. 1437 of 2017]
means in respect of a person that—
| (a) | is a company, that another person, directly or indirectly, alone or together with a related or inter-related person— |
| (i) | holds at least 15% of the issued shares of the first mentioned person; |
| (ii) | has the ability to exercise or control the exercise of at least 15% of the voting rights attached to securities of the first mentioned person; |
| (iii) | has the ability to dispose of or control the disposal of at least 15% of the first mentioned person's securities; or |
| (iv) | holds rights in relation to the first mentioned person that, if exercised, would result in that other person, directly or indirectly, alone or together with a related or inter-related person— |
| (aa) | holding at least 15% of the securities of the first mentioned person; |
| (bb) | having the ability to exercise or control at least 15% of the voting rights attached to shares or other securities of the first mentioned person; or |
| (cc) | having the ability to dispose of or direct the disposal of at least 15% of the first mentioned person's securities; |
| (b) | is a close corporation, that another person, directly or indirectly, alone or together with a related or inter-related person, holds at least 15% of the members' interests or controls, or has the right to control, at least 15% of members' votes in the close corporation; |
| (c) | is a trust, means that another person has, directly or indirectly, alone or together with a related or inter-related person— |
| (i) | the ability to exercise or control the exercise of at least 15% of the votes of the trustees; |
| (ii) | the power to appoint at least 15% of the trustees; or |
| (iii) | the power to appoint or change any beneficiaries of the trust; |
[Definition inserted by regulation 7(m) of Notice No. 1437 of 2017]
has the meaning assigned to in section 1 of the Companies Act;
[Definition inserted by regulation 7(n) of Notice No. 1437 of 2017]
"renew"
means any act that results in the renewal or reinstatement of an insurer's liability to provide policy benefits under a policy where the person performing the act may do so without the insurer becoming aware of the act until after the act has been performed;
"representative"
has the meaning assigned to it in regulation 3.1, but excludes any natural person;
[Definition substituted by regulation 7(o) of Notice No. 1437 of 2017]
"settle a claim"
means any act that results in—
| (a) | the acceptance of partial or full liability under a claim for policy benefits or a part thereof; |
| (b) | the determination of the liability of an insurer under a claim for policy benefits; or |
| (c) | the rejection of or refusal to pay a claim for policy benefits or a part thereof; |
where the person performing the act may do so without the insurer becoming aware of the act until after the act has been performed;
means a person that, directly or indirectly, alone or together with a related or inter -related person, has the ability to control or influence materially the business or strategy of another person. A person has the ability referred to in that subsection if—
| (a) | the person, directly or indirectly, alone or together with a related or interrelated person, has the power to appoint 15% of the members of the governing body of the other person; |
| (b) | the consent of the person, alone or together with a related or inter-related person, is required for the appointment of 15% of the members of a governing body of the other person; or |
| (c) | the person, directly or indirectly, alone or together with a related or interrelated person, holds a qualifying stake in the other person; |
[Definition inserted by regulation 7(p) of Notice No. 1437 of 2017]
"this Part"
means this Part 6;
has the meaning assigned to it in section 1 of the Insurance Act;
[Definition inserted by regulation 8(c) of Notice No. 1015, GG 41942, dated 28 September 2018]
"underwriting manager"
means a person that—
| (a) | performs one or more binder function; and |
| (b) | if that person renders services as an intermediary as defined in Part 3A of the Regulations— |
| (i) | does not perform any act directed towards entering into, maintaining or servicing a policy on behalf of an insurer, a potential policyholder or policyholder (including the performance of such an act in relation to a fund, a member of a fund and the agreement between the member and the fund); and |
| (ii) | renders those services (other than the services referred to in paragraph (i) above) to or on behalf of an insurer only; and |
| (c) | does not have any relationship with an insurer (including the secondment of that person's employees to an insurer or an associate of an insurer, the outsourcing of that person's infrastructure to an insurer or an associate of an insurer, or any similar arrangement) which may result in that person or its employees de facto, directly or indirectly, performing any act directed towards entering into, varying or renewing a policy on behalf of an insurer, a potential policyholder or policyholder; and |
[Definition substituted by regulation 7(q) of Notice No. 1437 of 2017]
"vary"
means any act that results in the variation, termination, repudiation or denial of an insurer's liability to provide policy benefits under a policy where the person performing the act may do so without the insurer becoming aware of the act until after the act has been performed, and includes any act declaring a policy void.