RISK MANAGEMENT AND INTERNAL CONTROLS
STANDARDS FOR INSURANCE COMPANIES
2
Table of Contents
Subject Page
Article 1 Definitions 3
Article 2 Systems of Risk Management and Internal Controls 7
Article 3 Effective Risk Management System 8
Article 4 Effective System of Internal Controls 11
Article 5 Control Functions 12
Article 6 Risk Management Function 12
Article 7 Risk Measurement & Use of Models 13
Article 8 Stress Testing of Material Risks 14
Article 9 Compliance Function 15
Article 10 Actuarial Function 16
Article 11 Internal Audit Function 17
Article 12 Outsourcing 18
Article 13 Countering Fraud in Insurance 22
3
INTRODUCTION
- These Standards form part of the Risk Management and Internal Controls Regulation for
Insurance Companies (Circular No. 25/2022 dated 30 December 2022). All Companies must
comply with these Standards which expand on the Regulation. These Standards are mandatory
and enforceable in the same manner as the Regulation.
- A Company’s Board is in ultimate control of the Company and therefore responsible for
ensuring that a comprehensive approach to the systems of Risk Management and Internal
Controls is implemented. There is no one-size-fits-all or single best solution. Accordingly,
each Company could meet the minimum requirements of the Regulation and Standards in a
different way and thus may adopt an organisational framework appropriate to the Risk Profile,
nature, size and complexity of its business and structure. The onus is on the Board to
demonstrate that it has implemented a comprehensive approach to systems of Risk
Management and Internal Controls. Companies are encouraged to adopt leading practices that
exceed the minimum requirements of the Regulation and Standards.
- The Standards follow the structure of the Regulation, with each article corresponding to the
specific article in the Regulation.
Article (1): DEFINITIONS
An entity that, directly or indirectly, is controlled by, or is under
common control with another entity. The term control as used herein
shall mean the holding, directly or indirectly, of voting rights in
another entity, or of the power to direct or cause the direction of the
management of another entity.
- Affiliate:
The person appointed by the foreign insurance company to manage
its branch in the State.
Authorized
Manager:
- Board: The Company’s board of directors.
- Central Bank: The Central Bank of the United Arab Emirates.
The most senior executive appointed by the Board, and in the case of
foreign branches, this refers the Authorized Manager.
Chief Executive
Officer:
Decretal Federal Law No. (14) of 2018 Regarding the Central Bank &
Organization of Financial Institutions and Activities, as amended and
Federal Law No. (6) of 2007 Concerning the Organization of Insurance
Operations, as amended and its Executive Regulations.
6. Central Bank Laws:
The insurance company incorporated in the State, or a foreign branch
of an insurance Company, that is licensed to underwrite primary
insurance and reinsurance, including Takaful insurance companies.
7. Company:
A situation of actual or perceived conflict between the duty and private
interests of a person, which could improperly influence the
performance of his/her duties and responsibilities.
8. Conflict of Interest:
4
Account or other data relating to a Company customer, who is or can
be identified, either from the Confidential Data, or from the
Confidential Data in conjunction with other information that is in, or
is likely to come into, the possession of a person or organization that
is granted access to the Confidential Data.
9. Confidential Data:
Function (whether in the form of a person, unit or department) that has
a responsibility in a Company to provide objective assessment,
reporting and/or assurance; this includes the risk management,
compliance, actuarial, internal audit and where applicable Shari’ah
control and Shari’ah audit functions.
10. Control Function:
A shareholder who has the ability to directly or indirectly influence or
control the appointment of the majority of the Board, or the decisions
made by the Board or by the general assembly of the Company,
through the ownership of a percentage of the shares or stocks or under
an agreement or other arrangement providing for such influence.
Controlling
Shareholder:
11.
The strategies, policies and processes of identifying, assessing,
measuring, monitoring, controlling, reporting and mitigating risks in
respect of the Company’s enterprise as a whole.
Enterprise Risk
Management
(ERM):
12.
Insurance Authority Board of Directors’ Decision No. (25) of 2014
Pertinent to Financial Regulations for Insurance Companies and the
Insurance Authority Board of Directors’ Decision No. (26) of 2014
Pertinent to Financial Regulations for Takaful Insurance Companies.
Financial
Regulations:
13.
A group of entities which includes an entity (the ‘first entity’) and:
a. any Parent of the first entity;
b. any Subsidiary of the first entity or of any Parent of the first
entity;
c. any Affiliate.
14. Group:
A set of processes, polices and activities governing a Company’s
organisational and operational structure, including reporting and
control functions.
15. Internal Controls:
Any person licensed to practice any of the activates of an insurance
agent, actuary, insurance broker, surveyor and loss adjuster, insurance
consultant or any other insurance-related profession that the Central
Bank decides to regulate.
Insurance Related
Professions:
16.
A quantitative method, system, or approach that applies statistical,
economic, financial, or mathematical theories, techniques, and
assumptions to process input data into quantitative estimates.
17. Model:
5
An arrangement between a Company and a service provider, whether
the service provider operates within or outside the UAE, for the latter
to perform a process, service or activity which would otherwise be
performed by the Company itself.
18. Outsourcing:
an internal process undertaken by a Company/ Group to assess the
adequacy of its Risk Management and current and prospective
solvency positions under normal and severe stress scenarios. It requires
a Company to analyze all reasonably foreseeable and relevant material
risks. It covers current and future risks and requires Company-specific
judgment about risk management and the adequacy of their capital
position that could have an impact on it’s ability to meet both its
business objectives as well as its policyholder obligations. This
encourages management to anticipate potential business challenges,
capital needs and to take proactive steps to reduce risks. ORSA is not
a one-off exercise; it is a continuously evolving process and must be a
component of a Company’s Enterprise Risk Management (ERM)
framework. Whilst there is not one specific way of conducting an
ORSA, the output is expected to be a set of documents that demonstrate
the results of management's proactive approach to its own selfassessment.
Own Risk and
Solvency
Assessment
(ORSA):
19.
An entity (the 'first entity') which:
a. holds a majority of the voting rights in another entity (the 'second
entity');
b. is a shareholder of the second entity and has the right to appoint
or remove a majority of the Board of directors or managers of the
second entity; or
c. is a shareholder of the second entity and controls alone, pursuant
to an agreement with other shareholders, a majority of the voting
rights in the second entity; or
d. if the second entity is a Subsidiary of another entity which is itself
a Subsidiary of the first entity.
20. Parent:
Any resolution, regulation, circular, rule, standard or notice issued by
the Central Bank.
21. Regulations:
The aggregate level and types of risk a Company is willing to assume,
within its risk capacity, to achieve its strategic objectives and business
plan.
22. Risk Appetite:
The set of norms, values, attitudes and behaviors of a Company that
characterizes the way in which it conducts its activities related to risk
awareness, risk taking and risk management and controls.
23. Risk Culture:
As part of the overall approach to Corporate Governance, the
framework through which the Board and Senior Management establish
Risk Governance
System:
24.
6
and make decisions about the Company’s strategy and risk approach;
articulate and monitor adherence to the Risk Appetite and Risks Limits
relative to the Company’s strategy; and identify, measure, manage, and
control risks.
Quantitative measure based on a Company’s Risk Appetite which
gives clear guidance on the level of risk to which the Company is
prepared to be exposed and is set and applied in aggregate or individual
units such as risk categories or business lines.
25. Risk Limits:
Point in time assessment of the Company’s gross and, as appropriate,
net risk exposures aggregated within and across each relevant risk
category based on forward looking assumptions.
26. Risk Profile:
The process through which risks are managed allowing all risks of a
Company to be identified, assessed, monitored, mitigated (as needed)
and reported on a timely and comprehensive basis.
27. Risk Management:
The individuals or body responsible for managing the Company on a
day-to-day basis in accordance with strategies, policies and procedures
set out by the Board, generally including, but not limited to, the Chief
Executive Officer, chief financial officer, chief risk officer, and heads
of the compliance and internal audit functions.
Senior
Management:
28.
All the persons working for a Company including the members of
Senior Management, except for the members of its Board.
29. Staff:
30. State: The United Arab Emirates.
A method of assessment that measures the financial impact of stressing
one or more factors which could severely affect the Company.
31. Stress Testing:
An entity (the 'first entity') is a Subsidiary of another entity (the
'second entity') if the second entity:
a. holds a majority of the voting rights in the first entity
b. is a shareholder of the first entity and has the right to
appoint or remove a majority of the Board of directors or
managers of the first entity; or
c. is a shareholder of the first entity and controls alone,
pursuant to an agreement with other shareholders, a
majority of the voting rights in the first entity; or
d. if the first entity is a Subsidiary of another entity which is
itself a Subsidiary of the second entity.
32. Subsidiary:
A collective contractual arrangement aiming at achieving cooperation
among a group of participants against certain risks whereby each
33. Takaful Insurance:
7
participant pays certain contribution fees to form an account called the
participants' account through which entitled compensations are paid to
the member in respect of whom the risk has realized. The Takaful
Insurance Company shall manage this account and invest the funds
collected therein against certain remuneration.
2. SYSTEMS OF RISK MANAGEMENT AND INTERNAL CONTROLS
- A Company must establish, implement and maintain systems of Risk Management and
Internal Controls that enable it to identify, assess, measure, monitor, control, mitigate and
report on risk. Systems of Risk Management and Internal Controls will vary with the specific
circumstances of the Company, particularly the Risk Profile, nature, scale and complexity of
its business and structure.
- The Board is responsible for the implementation of an effective Risk Culture and Internal
Controls across the Company and its Subsidiaries, Affiliates and international branches, where
applicable. The Board approved systems of Risk Management and Internal Controls must
incorporate a “three lines of defense” approach which includes the business lines being the
first line, Control Functions of Risk Management, compliance and actuarial, being the second
line and an independent and effective internal audit function as the third line.
a. Business line management – must take the responsibility of identification and control of
risks. The business line management must :
- Manage and identify risks arising from the activities of the business line;
- Ensure that activities are within the Company’s Risk Appetite, Risk Management
policies and limits;
- Design, implement and maintain effective system of Internal Controls; and
- Monitor and report on business line risks.
b. Risk Management, actuarial and compliance functions- must take responsibility for setting
standards and challenging business lines. The following must be adhered to:
- The Risk Management function must establish Company-wide, or if applicable,
Group-wide risk and control strategies and policies, provide oversight and
independent challenge of business lines’ accountabilities, develop and
communicate risk and control procedures, and monitor and report on compliance
with Risk Appetite, policies and Risk Limits.
- The Compliance function must assess Company-wide adherence to requirements,
develop and communicate compliance policies and procedures, measure, monitor
and report on compliance with Central Bank laws and other relevant laws,
corporate governance and Internal Controls rules, Regulations and policies to
which the Company is subject.
- The actuarial function must provide advice on technical provisions, premium and
pricing activities, capital adequacy, reinsurance and compliance with related
statutory and regulatory requirements, at a minimum.
8
c. Internal audit function has the duty of providing independent assurance. The function is
responsible to the following matters, at a minimum:
- Independently assess the effectiveness and efficiency of the Internal Controls,
Risk Management and governance systems and processes.
- Independently assess the effectiveness of business line management in fulfilling
their mandates and managing risks.
- The Risk Management and Internal Controls systems must be comprised of the following at
a minimum:
a. Strategies setting out the approach of the Company to dealing with specific areas of
risk and regulatory obligations in accordance with the Company’s nature, Risk
Profile, scale and complexity.
b. Policies defining the procedures and other requirements that members of the Board
and Staff need to follow in order to ensure consistency in approach.
c. Process for the implementation of the Company’s strategies and policies in order to
ensure completeness in approach.
d. Controls to ensure that strategies, policies and processes are in fact in place, are
being observed and are attaining their intended objectives in order to ensure
adequacy and appropriateness in approach.
- EFFECTIVE RISK MANAGEMENT SYSTEM
- The Risk Management system must address the following:
a.Identification:
- All reasonably foreseeable and relevant material risks are taken into consideration.
- New activities and products must be subject to risk review and must be approved by the
Board, including strategic affairs, such as corporate strategy, mergers, acquisitions,
major projects and investments.
b. Assessment:
- Qualitative and quantitative assessments of all reasonably foreseeable and relevant
material risks and risk interdependencies for risk and capital management.
- Quantification of risk and risk interdependencies using appropriate tools under a
sufficiently wide range of techniques for risk and capital management.
- As necessary, include the results of Stress Testing to assess the resilience of the
Company’s total balance sheet against severe but plausible stresses including
considerations of macroeconomic stresses.
9
c. Monitoring:
Early warning indicators that enable the appropriate response to all identified material
risks. This shall reflect the relationship between the Company’s Risk Appetite, Risk
Limits, regulatory capital requirements, economic capital and the processes and methods
for monitoring risk.A Company must have its own view on how much capital it needs over
and above the regulatory capital to fulfill its wider economic needs and manage risks.
d. Mitigation:
- Strategies and tools are in place to mitigate material risks.
- The Company must reduce or control material risks to within Risk Appetite and Risk
Limits, or transfer to/share with a third party.
- If a Company cannot mitigate or control the risk, then it must cease or change the
activity.
e. Reporting:
- Risks and assessments must be reported to the Board using qualitative and quantitative
indicators, including ORSA along with effective action plans, at least annually.
- The Board is ultimately responsible for risk oversight. The Risk Management policy
covers the frequency of reporting. Any deviation from Risk Appetite is subject to
Board review and approval.
f. Risk Management policies:
- Must enable Staff to understand their risk responsibilities.
- Must explain the relationship between the Risk Management system and how it
addresses risks according to the insurer’s Risk Appetite and Risk Limits, and the overall
corporate governance framework.
- Must outline how relevant material risks are managed.
- On-going communication and training on risk policies must be conducted.
- Groups must adopt a strong and consistent Risk Management and compliance culture across
the Group and at the entity levels. Coordination between the Group and the Company is
required to ensure the overall effectiveness of Risk Management and Internal Controls.
- The Risk Appetite statement is a written articulation of the aggregate level and types of risk
that a Company is willing to accept or avoid in order to achieve its business objectives. At a
minimum, it must include the following:
a. For each material risk, the maximum level of risk that the Company is willing to
operate within, expressed as a limit in terms of:
- Quantitative measures expressed relative to earnings, capital, liquidity and other
relevant measures as appropriate.
10
2. Qualitative statements or limits, as appropriate, particularly for reputation,
compliance and legal risks.
b. Delineation of any categories of risk that the Company is not prepared to assume.
c. The process for ensuring that the Risk Limits are set at an appropriate level for each
risk, considering both the probability of loss and the magnitude of loss in the event
that each material risk is realised.
d. The process for monitoring compliance with each Risk Limit and for taking
appropriate action in the event that they are breached.
e. The timing and process for review of the Risk Appetite and Risk Limits.
f. Quantitative Risk Limits and metrics must include, but not be limited to:
- Capital targets beyond regulatory requirements, such as economic capital or
capital-at-risk;
- Various liquidity ratios and survival horizons;
- Earnings volatility;
- Value at risk;
- Risk concentrations by internal or external rating;
- Expected loss, expense, commission and/or combined ratios;
- Economic value added; and
- Stressed targets of capital, liquidity and earnings.
- Underwriting risk, including growth and renewal rates of business, risk
retention, balance between lines of business, premium rate adequacy versus
technical rates, and claim settlement.
- Credit risk, including credit quality of reinsurers, credit quality of investment
assets and receivable delay management.
- Investment risk, including asset allocations to achieve adequate diversification
and target investment returns. This must be linked to the asset-liability
management (ALM) policy and investment policy which specifies the nature,
role and extent of ALM activities and their relationship with product
development, pricing and investment management.
- Operational risk, including consideration of risks arising from people, systems,
processes as well as cyber security.
11
4. EFFECTIVE SYSTEM OF INTERNAL CONTROLS
- The Board or the Board audit committee must review, at least annually, the effectiveness of
the Company’s Internal Controls system and processes, by means of:
a. Periodic discussions with Senior Management about the effectiveness of the Internal
Controls system.
b. A timely review of evaluations of Internal Controls conducted by Senior Management,
internal auditors, the Risk Management function and external auditors.
c. Periodic follow up to ensure that Senior Management has promptly complied with the
recommendations and concerns on control weaknesses expressed by Risk Management,
internal auditors and external auditors and the Central Bank.
d. A periodic review of the appropriateness of the internal controls, commensurate to the
Company’s strategy and Risk Limits.
- The Company’s Internal Controls system must, at a minimum, address:
a. Organisational structure: definitions of duties and responsibilities including clear
delegations of authority, such as decision-making policies and processes and procedures,
separation of critical functions, including, but not limited to, Risk Management, actuarial,
accounting, audit and compliance.
- The Risk Management system must include risk policies that cover at least the following
areas:
a. Credit risk;
b. Balance sheet and market risk (including investment, asset-liability management,
liquidity and derivatives risks);
c. Reserving risk;
d. Insurance risk (including underwriting, product design, pricing and claims settlement
risks);
e. Reinsurance risk;
f. Operational risk (including business continuity, outsourcing, fraud, technology, legal
and project management risks);
g. Concentration risk; and
h. Group risk.
12
b. Accounting and financial reporting policies and processes.
c. Checks and balances (or “four eyes” principle): segregation of duties, cross checking, dual
control of assets and double signatures.
d. Safeguarding assets and investment: physical control and computer access, measures of
prevention and early detection and reporting of misuse, such as fraud, embezzlement,
unauthorised trading and computer intrusion.
5. CONTROL FUNCTIONS
- The authority and responsibilities of each control function must be set out in writing and made
part of the Company’s governance documentation.
- Staff who perform Control Functions must be suitable for their role and meet any applicable
professional qualifications and standards. Higher expectations must be placed on the head
of each control function.
- The head of each control functions must regularly review the adequacy of the function’s
resources and request adjustments from Senior Management/ Board as necessary.
- Each control function must have the authority to communicate on its own initiative with any
employee and to have unrestricted access to information in any business unit that it needs to
carry out its responsibilities. The control functions must have the right to conduct
investigations of possible breaches and to request assistance from specialists from within or
outside of the Company.
- RISK MANAGEMENT FUNCTION
- The Risk Management function must have responsibility for the following, at a minimum:
a. Providing risk analysis and performance risk reviews to the Board and Senior
Management;
b. Identifying individual and aggregated risks (actual, emerging and potential) that the
Company faces;
c. Identifying, assessing, monitoring, mitigating, controlling and reporting risks, including
the Company’s capacity to absorb risk with due regard to the nature, probability, duration,
correlation and potential severity of risks;
d. Gaining and maintain an aggregated view of the Risk Profile of the Company on an entity
and/or Group-wide basis;
13
7. RISK MEASUREMENT AND THE USE OF MODELS
- A Company must use measurement methodologies commensurate with the Risk Profile,
nature, size and complexity of the business and the structure of the Company, including, but
not limited to, scenario analysis and Stress Testing. Common metrics must be employed on
a Company (or Group)-wide basis to foster a Company (or Group)-wide approach and
effective identification and monitoring of risks across the Company (or Group).
e. Assessing the impact of the compensation arrangements and incentives;
f. Evaluating the internal and external risk environment on an on-going basis in order to
identify and assess potential risks as early as possible. This may include looking at risks
from different perspectives, such as by geographic region or by line of business;
g. Establishing a process for conducting forward-looking assessments of the Risk Profile on
a regular basis;
h. Providing periodical reports to the Board, Senior Management and other Control
Functions on the Risk Profiles, risk exposures and the necessary mitigation actions; and
i. Reporting material changes affecting the Risk Management system to the Board along
with recommendations to improve the system.
- The CRO, or equivalent, must:
a. Not have a decision-making role in the Company’s risk-taking functions, including
underwriting or other equivalent function.
b. Have no revenue-generating responsibilities.
c. Have no compensation based on the performance of any of the Company’s risk-taking
functions.
d. Not be the Chief Executive Officer of the Company, or the head of underwriting or
reinsurance, or the head of the compliance or internal audit functions.
e. Have a direct reporting line to the Board and/or risk committee and appropriate reporting
lines to Senior Management.
f. Have unfettered access directly to the Board’s risk committee, including the ability to
meet without other Senior Management present.
- The Board must ensure that the Risk Management function is properly staffed, resourced and
carries out its responsibilities independently and effectively. This includes unrestrained access
to all information needed for the Risk Management function to fulfill its duties.
14
2. Risk measurement and modelling techniques must be used in addition to qualitative risk
analysis and monitoring. The comprehensive approach to risk management must include
policies and procedures for the development and internal approval for the use of Models or
other risk measurement methodologies. Where the Models, or data for the Models, are
supplied by a third party, there must be a process for the validation of the Model and data
relative to the specific circumstances of the Company.
3. A Company must perform regular validation and testing of Models. This must include
evaluation of the conceptual soundness, ongoing monitoring including process verification
and benchmarking and outcomes analysis, including back-testing. Stress Testing and scenario
analysis must be used to take into account the risk of Model error and uncertainties associated
with valuations and concentration risks.
4. Model-based approaches must be supplemented by other measures. These include qualitative
assessment of the logic, judgement and types of information used in Models, as well as
assessment of policies, procedures, Risk Limits and exposures, especially with respect to
difficult to quantify risks such as operational, compliance and reputational.
8. STRESS TESTING OF MATERIAL RISKS
- A Company must have a forward looking Stress Testing programme that addresses inter alia,
underwriting, reserving, asset-liability management, investments, liquidity, reinsurance,
concentration of risk, operational risk, risk-mitigation techniques and conduct of business ,
taking into account, that based on the Risk Profile of the Company, capital may be required
in excess of the minimum capital requirements. The Stress Testing programme must also
include any risks that are material for the Company given the nature of the business. These
may include, but are not limited to, Credit risk, balance sheet and market risks, reserving;
pricing, claims, reinsurance, operational, concentration and Group risks.
- A Company’s Stress-Testing programme must be undertaken on a regular basis to facilitate
the tracking of trends over time and developments in key risk factors and exposure amounts,
in addition to ad hoc Stress Tests, when needed. The programme must cover at a minimum a
range of scenarios based on reasonable and plausible assumptions regarding dependencies
and correlations. Senior Management and, as applicable, the Board or Board risk committee
must review and approve the scenarios.
- Stress Test programme results must be periodically reviewed by the Board or the Board risk
committee. Results must be incorporated into reviews of the Risk Appetite, capital and
liquidity planning processes. The Risk management function is responsible for
recommending any action required, for example adjustments of Risk Limits or contingency
arrangements, based on Stress Test results. The results of Stress Tests and scenario analysis
must be communicated to the relevant business line management and functional heads within
the Company to assist them in understanding and mitigating the risks inherent in their
activities. Stress test programme results must factor into the Company’s contingency
planning, particularly liquidity Risk Management and contingency funding.
15
9. COMPLIANCE FUNCTION
- Compliance Staff must have a sound understanding of the Central Bank laws and other
relevant laws, Regulations, rules and standards, relevant to the Company’s business and keep
abreast with their development and any amendments thereof. The professional skills of
compliance Staff must be maintained through regular and systematic education and training,
including courses on real cases relating to money laundering, financing of terrorism and
proliferation financing.
- The compliance function must have access to any member of Staff and all records and data
of the Company, and if applicable, the Company’s Affiliates and Subsidiaries, which are
required to comply with the Central Bank’s requirements.
- A consistent approach to compliance across the Group may be achieved through the
establishment of a Group compliance function accountable to the Board of the Controlling
Shareholder, or through compliance functions established in each entity (or branch) and
accountable to those entities’ Boards and also reporting to the Group’s head of compliance.
- The compliance function must be assigned responsibility for the following, at a minimum:
a. Establishing a compliance policy and a compliance plan. The compliance policy must
define the responsibilities, competencies and reporting duties of the compliance
function. The compliance plan must set out the planned activities of the compliance
function which take into account all relevant areas of the activities of the Company and
exposure to compliance risk.
b. Assessing the adequacy of the measures adopted by the Company to prevent noncompliance with Central Bank Laws and Regulations.
c. Maintaining a corporate culture that is based on responsible conduct and compliance
with internal and external obligations.
d. Identifying, assessing, monitoring, mitigating, reporting on, and addressing regulatory
obligations and the risks associated therewith.
e. Conducting on-going training on regulatory obligations for Staff responsible for high
risk activities.
f. Enabling confidential reporting by Staff regarding any breach of legal or regulatory
obligations or internal policies.
g. Addressing any instances of non-compliance and ensuring that disciplinary action is
taken, along with the required reporting to the Central Bank.
16
10. ACTUARIAL FUNCTION
An effective actuarial function must be well resourced and properly authorised and staffed as
it plays a major role in the Company’s overall system of Risk Management and Internal
Controls. The actuarial function conducts all the actuarial undertakings per Article (10) of
the Regulation, which must include, among other undertakings, the following:
- Applying methodologies and procedures to assess the sufficiency of the Company’s
liabilities, including policy provisions and aggregate claim liabilities, as well as
determination or reserves for financial risks and to ensure that their calculation is
consistent with the requirements set out in the Financial Regulations. This must also
include assessing the uncertainty associated with the estimates made in the calculation
of the Company’s liabilities;
- Asset liability management with regards to the adequacy and the sufficiency of assets
and future revenues to cover the Company’s obligations to policyholders and capital
requirements, as well as other obligations or activities;
- Reviewing the Company’s investment policies and completing the valuation of assets;
- The solvency position of the Company, including a calculation of minimum capital
required for regulatory purposes and liability and loss provisions;
- Advising on the Company’s prospective solvency position by conducting capital
adequacy assessments and Stress Tests under various scenarios, and measuring their
relative impact on assets and/or liabilities, and actual and future capital levels;
- Developing risk assessment and management policies and controls relevant to actuarial
matters or the financial condition of the Company;
- Ensuring the fair treatment of policyholders with regard to distribution of profits
awarded to them, when their policies contain elements of bonus/dividend.
- Ensuring the adequacy and soundness of underwriting policies, which must at least
include conclusions on the following matters:
a. Sufficiency of the premiums to be earned to cover future claims and expenses,
taking into consideration the underlying risks (including underwriting risks), and
the impact of options and guarantees included in insurance and reinsurance
contracts;
b. The effect of inflation, legal risk, change in the composition of the Company's
portfolio, and of systems which adjust the premiums policy-holders pay upwards or
downwards depending on their claims history (bonus-malus systems) or similar
systems, implemented in specific homogeneous risk groups; and
c. The progressive tendency of a portfolio of insurance contracts to attract or retain
insured persons with a higher risk profile (anti-selection).
- The development, pricing and assessment of the adequacy of reinsurance
arrangements must include analysis of the following matters:
a. The Company's risk profile and underwriting policy;
17
b. Reinsurance providers, taking into account their credit standing;
c. The expected cover under stress scenarios in relation to the underwriting policy;
and
d. The calculation of the amounts recoverable from reinsurance contracts and
special purpose vehicles, if any.
10. Product development and design, including the terms and conditions of insurance
contracts and pricing, along with estimation of the capital required to underwrite the
product;
11. Ensuring the sufficiency, accuracy and quality of data, the methods and the
assumptions used in the calculation of technical provisions and ensure that any
limitations of data used to calculate technical provisions are properly dealt with;
12. Comparing best estimates against experience, review the quality of past best
estimates and use the insights gained from this assessment to improve the quality of
current calculations. The comparison of best estimates against experience shall
include comparisons between observed values and the estimates underlying the
calculation of the best estimate, in order to draw conclusions on the appropriateness,
accuracy and completeness of the data and assumptions used as well as on the
methodologies applied in their calculation.
13. Reporting to the Board and Senior Management on the calculation of the Company’s
insurance liabilities which must include at least a reasoned analysis on the reliability
and adequacy of their calculation and on the sources and the degree of uncertainty of
the estimates. That reasoned analysis shall be supported by a sensitivity analysis that
includes an investigation of the sensitivity to each of the major risks underlying the
obligations which are covered in the Company’s liabilities. The actuarial function
shall clearly state and explain any concerns it may have concerning the adequacy of
Company’s liabilities.
14. The actuarial function must produce a written report to be submitted to the Board, at
least annually. This report must document all of the tasks that have been undertaken
by the actuarial function and a summary of their results, and must clearly identify
any deficiencies and give recommendations as to how such deficiencies must be
remedied.
15. Any other actuarial or financial matters determined by the Board.
11. INTERNAL AUDIT FUNCTION
The internal audit function must be responsible for the following matters, at a minimum:
- Establishing, implementing and maintaining an audit plan, setting out the audit work
to be undertaken in the upcoming years, taking into account all activities and the
Company’s complete system of governance. The plan must be developed taking a riskbased approach in deciding its priorities and the audit plan must be presented to the
Board for approval. Where necessary, the internal audit function may carry out audits
which are not included in the audit plan.
18
2. Disclosing any adverse matters affecting the function’s independence.
3. Disclosing any material findings, and the extent of management’s compliance with
agreed upon corrective measures.
4. Conducting risk-based audits to assess the Company’s alignment with the Company’s
Risk Culture, Risk Appetite, Risk Profile and Risk Limits.
5. Assessing the Company’s processes, policies and the documentation thereof on an
entity and Group-wide basis and on an individual Subsidiary and business unit basis.
6. Assessing the employees’ and business units’ compliance with applicable Central Bank
Laws, Regulations and internal controls.
7. Assessing the reliability of management information systems and processes.
8. Evaluating the methods of safeguarding Company and policyholder assets and, as
appropriate, verifying the existence of such assets and the required level of segregation
in respect of Company and policyholder assets;
9. Monitoring and evaluating the effectiveness of the Company's other Control Functions,
particularly the Risk Management, actuarial and compliance functions.
10. Coordinating with the external auditors and, to the extent requested by the Board and
consistent with applicable law, evaluating the quality of performance of the external
auditors.
11. Issuing recommendations based on the result of work carried out in accordance with
the audit plan and submit a written report on the findings and recommendations to the
Board on at least an annual basis;
12. Verifying compliance of Senior Management with the decisions taken by the Board on
the basis of those recommendations referred to in the internal audit report.
12. OUTSOURCING
- The Risk Governance System must, at a minimum, provide for the following with respect to
Outsourcing:
a. A Board-approved policy that sets out how the materiality of a proposed Outsourcing
arrangement is assessed and requiring any material Outsourcing arrangements to be
approved by the Board, or the risk/audit committee of the Board;
b. Policies and procedures to ensure that potential Conflicts of Interest are identified,
managed and appropriately mitigated, or avoided;
c. Policies and procedures that clearly identify and assign to the Company’s departments,
committees, Internal Controls functions, and other individuals, the roles and
responsibilities with regard to Outsourcing and determine in which cases and at which
stage, they must be involved;
19
d. Policies and procedures to ensure that all material risks related to Outsourcing are
identified, assessed, measured, monitored, controlled, mitigated, and reported to the
Board in a timely and comprehensive manner;
e. Ensure that any outsourced critical business functions are covered in their disaster
recovery and business continuity plans, that Outsourcing service providers are fully
prepared to implement them and that Outsourcing service providers have their own
disaster recovery and business continuity plans to resolve disruptions at their end.
2. All outsourced activity must be governed by written contracts that state the parties’ rights and
obligations. The Board and Senior Management must consider the effects on the Company’s
Risk Profile, and assess the service provider’s expertise, knowledge, governance, Risk
Management, Internal Controls, and financial viability along with the succession issues upon
the ending of the contractual relationship with the service provider. The Company must
conduct the following:
a. Perform a detailed examination to ensure that the potential service provider has the ability,
the capacity and any authorisation required by law to deliver the required functions or
activities satisfactorily, taking into account the Company’s objectives and needs;
b. Ensure The service provider has adopted all means to ensure that no explicit or potential
Conflict of Interests jeopardise the fulfilment of the deliverables of the outsourcing
Company;
c. Execute a written contract with the service provider which clearly defines the respective
rights and obligations of the Company and the service provider;
d. Ensure that the general terms and conditions of the outsourcing contract are clearly
explained to the Company’s Board and authorised by them;
e. Ensure that the outsourcing agreement does not entail the breaching of any law in
particular with regard to rules on data protection; and
f. Ensure that the service provider is subject to the same provisions on the safety and
confidentiality of information relating to the Company or to its policyholders or
beneficiaries that are applicable to the Company.
3. A Company must have an outsourcing register that contains key information for each
Outsourcing arrangement, and includes at a minimum:
a. Key non-risk related data, such as the details of the Outsourcing service provider, start
and end date of the arrangement, and a brief description of the services being provided.
b. Whether the Outsourcing arrangement involves any Confidential Data; and
c. Whether the Outsourcing arrangement is considered Material Business Activity.
4. a. Companies must ensure compliance with all the applicable State legislation and
regulations in managing and processing data, when using Outsourcing services.
b. Companies must ensure that they retain ownership of all data provided to an Outsourcing
service provider, and that their customers retain ownership of their data, including but not
limited to, Confidential Data, and can effectively exercise their rights and duties in this
regard.
20
c. Where the Outsourcing service provider subcontracts elements of the service which
involve Confidential Data, Companies must ensure that the subcontractor fully complies
with the applicable requirements as established by law and under this and other applicable
regulations.
d. Companies must ensure their data is secured from unauthorised access, including
unauthorised access and/or use by the Outsourcing service provider or its Staff.
5. a. Outsourcing agreements must ensure that the Company has unfettered access to all of its
data for the duration of the contract, including upon termination of the contract.
b. Outsourcing agreements must include appropriate provisions to protect a Company’s data,
including non-disclosure agreements and provisions related to the destruction of the data
and/or transfer to the Company upon termination of the agreement.
c. Outsourcing agreements must specifically establish standards for data protection,
including any nationally recognised information assurance and/or data protection and
confidentiality of information requirements in the State.
d. Outsourcing agreements must specifically establish that the Outsourcing service provider,
or any of its subcontractors must not provide any other party with access to Confidential
Data without first obtaining the specific authorisation of the Company, or the customer,
as the case may be.
e. Outsourcing agreements must specify to what extent subcontracting is allowed and under
what conditions.
f. Outsourcing agreements must include an explicit provision giving the Central Bank, and
any agent appointed by the Central Bank, access to the Outsourcing service provider. This
provision must include the right to conduct on-site visits at the Outsourcing service
provider, if deemed necessary by the Central Bank and require the Outsourcing service
provider to provide the Central Bank, or its appointed agent, any data or information
required for supervisory purposes.
g. Outsourcing agreements must include an obligation for the Outsourcing service provider
to notify the Company without undue delay of any breach of the Company’s data and in
particular, breaches of Confidential Data.
6. When Outsourcing outside of the State:
a. Any Outsourcing agreement with a party located outside of the State, must stipulate that
the Company and the customer retain ownership of the data at all times, and that the
Central Bank can access the Company’s data upon request.
b. A Company must explicitly consider the possibility that changes in economic, political,
social, legal or regulatory conditions may affect the ability of a service provider outside
of the State to fulfil the terms of the agreement. This risk must be managed by a careful
selection of service providers and jurisdictions, adequate contractual and practical
arrangements, and appropriate business continuity planning.
21
c. A Company must explicitly consider any other relevant risks arising when the service
provider is located outside of the State. These must include, but are not limited to:
- Higher levels of operational risk due to poor infrastructure in another jurisdiction;
- Legal risk due to differing laws and possible shortcomings in the legal system in the
countries where the service is provided; and
- Reputational risk due to the breach of the service agreement by the service provider.
d. A Company must ensure compliance with all relevant personal data protection legislation
and regulations prior to entering into an Outsourcing agreement with an Outsourcing
service provider or third party outside of the State.
e. A Company must establish policies, processes and procedures regarding controls and
monitoring activities specifically addressing the business relationship of the Company
with an Outsourcing service provider, which includes the sharing of Confidential Data
outside of the State.
f. For each of its business relationships a Company holds with an Outsourcing service
provider, which includes the sharing of Confidential Data outside of the State, the
Company must define concrete security requirements and must ensure that its Staff are
sufficiently trained in respect of these requirements.
g. Companies must ensure that third parties implement and maintain the appropriate level of
information security and service delivery.
h. With regard to Outsourcing service providers located outside of the State, the Central
Bank may exercise its powers through collaboration with the relevant authorities of any
relevant jurisdiction.
- Prior to Outsourcing any material activity, including to any related party, Companies must
obtain a prior notice of non-objection from the Central Bank. When requesting the nonobjection, Companies must provide the Central Bank with the following at a minimum:
a. A brief explanation of the business activity to be outsourced;
b. A summary of the materiality assessment;
c. A summary of the risk assessment;
d. A summary of the due diligence performed and its outcome;
e. A confirmation of the agreement of the internal audit function and the compliance
function;
f. An overview of any closely related outsourcing agreements;
g. Confirmation of compliance with the requirements of the Risk Management and Internal
Controls Regulation for Insurance Companies and these Standards.
h. Evidence of the approval of the proposed Outsourcing by the Board or Board committee.
22
The Central Bank will either grant the non-objection, request further information, or decline
the request. Companies are encouraged to discuss their material Outsourcing plans early and
coordinate with the Central Bank to avoid the non-objection process delaying the
Outsourcing.
8. Although all requests for non-objection will be considered on their individual merits, the
Central Bank, will in general, not permit the Outsourcing of core insurance activities, and
key management and Control Functions, including but not limited to Senior Management
oversight and internal audit. The Central Bank may determine adding further requirements in
this regard, from time to time
13. COUNTERING FRAUD IN INSURANCE
- A Company must have policies, procedures and controls to minimise the risk of internal
and external fraud in the following areas, at a minimum:
a. Product development;
b. Onboarding clients;
c. Hiring and dismissal Staff;
d. Outsourcing;
e. Claims’ management and settlements; and
f. Dealing with practitioners of Insurance Related Professions.
- Insurance fraud categories include:
a. Internal fraud, which is committed by a Board member, Senior Manager or other
member of Staff on his/her own or in collusion with others who are either internal or
external to the Company.
b. Insurance Related Professions’ fraud, which is committed by practitioners against the
Company, policyholders or beneficiaries.
c. Policyholder fraud, which is committed against the Company in the purchase and/or
execution of an insurance product by one or more persons by obtaining wrongful
coverage or payment.
- Preventive policies, procedures and controls to manage internal fraud must include:
a. Creating a culture based on integrity;
b. Developing and maintaining policy and guidelines on ethical behavior;
c. Adequate supervision of Staff;
d. Performing pre-employment and in-employment screening of permanent or
temporary Staff;
e. Documented job descriptions;
23
f. Periodical job rotation and mandatory vacations for Staff in fraud sensitive positions;
g. Observing the “four eyes” principle.
h. Segregation of duties;
i. Having procedural safeguards over the use, handling and availability of cash;
j. Establishing a transparent policy in dealing with internal fraud by Board members
and Staff, including a policy on reporting to the relevant law enforcement agency;
k. Establishing a clear dismissal policy for internal fraud cases in order to deter potential
perpetrators.
4. Preventive policies, procedures and controls to manage policyholder fraud must include:
a. Customer due diligence prior to inception.
b. Requesting additional supporting documents to verify the policyholder’s sources of
wealth.
c. In terms of claims settlement, procedures must include:
- Using professional judgement based on experience;
- Identifying red flag lists;
- Conducting peer reviews;
- Reviewing internal and/or external databases or other sources;
- Using information technology tools, such as voice stress analysis, data mining,
neural networks and tools to verify the authenticity of documents; and
- Interviewing claimants.
- Preventive policies, procedures and controls to manage Insurance Related Professions’ fraud
must include:
a. Having in place a documented policy and procedure for the appointment of new
practitioners of Insurance Related Professions.
b. Having an application form and terms of business agreement that have to be completed
and signed by the practitioners of Insurance Related Professions.
c. Ensuring the application form requires applicants to disclose relevant facts about
themselves, including qualifications, experience, and qualifying body.
d. Verifying the financial soundness of the applicant and checking references.
24
e. Having an effective sanction policy in case of non-compliance by the practitioners of
Insurance Related Professions.
6. A Company must collect information in respect of insurance fraud from the market and to
provide same to the Board and Staff. Such information must be used to evaluate the
effectiveness of policies, procedures and controls, and to make changes were necessary.
7. A Company must establish and maintain an independent audit function to test fraud, fraud
risk management, procedures and controls.
8. A Company must encourage Staff to report all irregularities and must have a whistle blowing
policy in place for this purpose.
9. A Company’s fraud management strategy must be aligned with the Risk Profile of the
Company. In determining the Risk Profile, the following factors must be taken into
consideration:
- size of the Company;
- organisational structure;
- products and services offered;
- payment methods used for premiums and claims;
- types of policyholder; and
- market conditions.
- A Company must retain records of all reported cases of fraud along with the findings, and
must establish standards relating to the turnaround time for the assessment of fraud,
documentation of analysis and keeping records of fraud incidents.
- A Company must have effective reporting systems to the Board in terms of frequency of
incidents, along with recommendations to address the issues.
- A Company must report any suspected or confirmed fraud cases to the proper law
enforcement authorities immediately and notify the Central Bank of such reporting.
- A Company must provide the Board and Staff with guidance on fraud indicators and training
on preventing, detecting, reporting and remedying fraud. Such training must be
commensurate with the position that the person holds within the Company.