Form Completion Instructions – Right of Establishment

INSTRUCTIONS FOR INTERMEDIARIES AND SECONDARY INTERMEDIARIES INTENDING TO CARRY OUT INSURANCE DISTRIBUTION ACTIVITIES IN ANOTHER MEMBER STATE ON THE BASIS OF THE RIGHT OF ESTABLISHMENT - FOE

Intermediaries or secondary intermediaries may carry out insurance distribution activities for which they have Hanfa's approval in the territory of another Member State:

• on the basis of the right of establishment, or
• in accordance with the freedom to provide services.

Each intermediary or secondary insurance intermediary intending to carry out insurance distribution activities on the basis of the right of establishment by setting up a branch or permanent presence in another Member State must:

• pursuant to Article 418(1) of the Insurance Act (Official Gazette Nos. 30/2015, 112/2018, 63/2020, 133/2020), notify Hanfa in writing using the form published on its website;
• pursuant to Article 12(47) of the Regulation on the Type and Amount of Fees of the Croatian Financial Services Supervisory Agency (Official Gazette No. 26/2019), submit proof of payment of the notification fee to the competent supervisory authority of the Member State and to the intermediary or secondary intermediary from the Republic of Croatia for carrying out insurance or reinsurance distribution activities in that Member State via a branch, in the amount of 1,000.00 HRK.

Instructions for completing the form:

1. The form must be completed exclusively in English.
2. The form must indicate whether it is an initial notification or a modification of the notification.
3. Under point 1, the first and last name of an individual intermediary/secondary intermediary or the name of a legal entity intermediary/secondary intermediary is provided.
4. Under point 2, the intermediary/secondary intermediary's Personal Identification Number (OIB) is provided.
5. Under point 3, the address (street, postal code, city, and country) of an individual intermediary/secondary intermediary or the registered office address (street, postal code, city, and country) of a legal entity intermediary/secondary intermediary is provided.
6. Under point 4, the registration number under which the intermediary/secondary intermediary is listed in the Intermediaries/Secondary Intermediaries Registers on Hanfa's website is provided.
7. Under point 5, the email address of the intermediary/secondary intermediary is provided, if available.
8. Under point 6, the name of the Member State where the intermediary/secondary intermediary intends to carry out insurance distribution activities on the basis of the right of establishment by setting up a branch is provided.
9. Under point 7, the category of the intermediary/secondary intermediary is provided in accordance with the categorization under Article 402 of the Insurance Act.
10. Under point 8, if applicable, the name of the insurance/reinsurance company represented by the intermediary/secondary intermediary is provided. If not applicable, "N/A" (non-applicable) is entered.
11. Under point 9, the types of insurance for which the intermediary/secondary intermediary is authorized are listed.
12. Under point 10, the name and address of the branch that the intermediary/secondary intermediary intends to establish are provided.
13. Under point 11, the first and last name of the person responsible for managing the branch or permanent presence is provided.
14. Under point 12, the name of the competent supervisory authority of the home Member State – Hanfa – is provided.
15. Under point 13, if the intermediary/secondary intermediary acts under the responsibility of one or more insurance/reinsurance companies or intermediaries, the names of those insurance/reinsurance companies or intermediaries for which the intermediary/secondary intermediary is registered for insurance distribution are provided (if applicable). If not applicable, "N/A" is entered.
16. Under point 14, the address of the online register where the intermediary/secondary intermediary can be found is provided – a link to Hanfa's website online register of intermediaries/secondary intermediaries in which the intermediary/secondary intermediary is listed must be entered.
17. Under point 15, if applicable, the nature of risk and obligations to be covered by insurance contracts that the intermediary/secondary intermediary intends to distribute in the host Member State are provided. If not applicable, "N/A" is entered.
18. Under point 16, the first and last name, phone number, and email address of the contact person for Hanfa regarding the notification are provided.
19. At the bottom of the form, the date, first and last name, title/position of the person completing the form, and their signature must be provided.
20. The completed form, together with the proof of fee payment, may be submitted electronically to Passport.Imd@hanfa.hr, by post, or in person at Hanfa's Registry Office on working days from 9 a.m. to 2 p.m.

Footnotes: 1 For easier navigation, reference is made to the Regulation on the Allocation of Risk Types by Groups and Insurance/Reinsurance Types. 2 For easier navigation, reference is made to the Regulation on the Allocation of Risk Types by Groups and Insurance/Reinsurance Types.

Note: Pursuant to Article 418(7) of the Insurance Act, if any data submitted in the form changes, the insurance intermediary/secondary intermediary must notify Hanfa in writing at least one month before the change takes effect. In this case, the intermediary/secondary intermediary must complete the form according to the instructions above, indicate that it is a modification of the notification, and submit the form to Hanfa, which will notify the competent authority of the host Member State as soon as possible, and no later than one month from the date of receipt of said data.

Instructions for fee payment: Initial Notification Amount: 1,000.00 HRK Model: 67 Reference Number: OIB-118-044 IBAN for payment: HR91 2390 0011 1003 29373. Purpose of payment: Initial Notification FOE – Party Name

Note: For notifications regarding changes to the data in the form, the intermediary/secondary intermediary is not required to pay Hanfa any fee. In the event that an intermediary/secondary intermediary intends to carry out insurance distribution activities on the basis of the right of establishment in multiple Member States, it may list multiple Member States in point 6 of the form during the initial notification. In such a case, the intermediary/secondary intermediary is required to pay a single fee for the initial notification.