Rule · SBS · 20 May 2016 · Resolución SBS 2829-2016

Microinsurance Policy Regulation

Companies marketing microinsurance must cap monthly premiums at 0.60% of the UIT, charge no additional amounts beyond the commercial premium, and provision 100% of premiums receivable after policy expiry, with 90-day non-payments requiring impairment provisions. Simplified policies must be delivered within 10 days of application, policy copies within 15 days of request, and renewal modification notices sent at least 45 days before expiry, with policyholders given 30 days to reject. Companies must submit Annex No. ES–16 semi-annually within 30 calendar days after each semester, and are liable for marketers' errors or omissions.

PeruSuperintendencia de Banca Seguros y AFP
Annotations and obligations
110 obligations · 15 permissions · 43 definitions
  • Obligation 110
  • Permission 15
  • Definition / condition 43
  • background, boilerplate

Lineage: Amended

A newer document in RegAlert amends this one; it applies as amended.

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The links and the sentences they come from (6)
Supersedes
Amended by
Amends
Issued under
  • Supreme Decree No. 001-2009-JUSNot in RegAlert

    “under the provisions of Supreme Decree No. 001-2009-JUS and its amending norms”

Mentions (1): 1 document this one mentions without changing it
Refers to

What changed in the obligations

Against SBS Resolution No. 14283-2009: Microinsurance Regulation (2009-10-29)

64 new obligations · 3 changed obligations · 3 deadlines changed · 5 changes of scope · 4 changes of who is bound · 24 not carried over

25 obligations are the same in both texts.

Changed (15)
  • Scope
    Before
    The simplified policy and the application-certificate that the insurance company, the marketer or the insurance broker deliver to the insured as proof of the granting of coverage must have the following minimum content: b) Identification of the insured, with the following minimum information:
    Now
    Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: e) Identification of the insured and date of birth, when applicable.
  • What must be done
    Before
    j) Deductibles, copayments and franchises are not applicable.
    Now
    Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: j) Deductible, franchise, coinsurance or copayment, when applicable according to the characteristics of the risks covered by the microinsurance.
  • What must be done
    Before
    If the form of contracting the insurance does not allow formal signing of the application, companies must provide mechanisms to verify that there was a coverage request for the company to have issued the respective policy.
    Now
    Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: n) Mechanisms enabled to submit queries or claims.
  • Who is bound
    Before
    The insurance company and/or insurance broker must make the pertinent arrangements so that the simplified policies are delivered by the marketers to the insured within ten (10) days of receipt.
    Now
    The simplified policies must be delivered to the policyholders within a maximum term of ten (10) days counted from the date on which the company or the marketer receives the insurance application.
  • Scope
    Before
    Copies of the signed application-certificates must be delivered to the insured at the time of contracting.
    Now
    The company or the marketer must deliver to the insured the microinsurance application-certificate, which accredits the contracting of the insurance, at the time of their incorporation into the insured group, which must contain the minimum information indicated in Annex N° 1 “Model Format of Microinsurance Application-Certificate” of this Regulation.
  • Scope
    Before
    The insurance company must keep evidence of the communication made.
    Now
    Likewise, companies must keep records of the delivery or making of these communications or of the shipments made by electronic means.
  • What must be done
    Before
    If it is necessary to make modifications to the policy conditions, the insurance company must use the necessary means so that each and every one of the insured persons becomes aware of such modifications, at least thirty (30) days in advance.
    Now
    During the term of the microinsurance, the terms of the contracted policy cannot be modified without the prior written approval of the policyholder, who shall have a period of thirty (30) days to make a decision regarding the proposed modifications, counted from the date on which they receive a communication from the company at their physical address, informing in highlighted characters of the mo…
  • Scope
    Before
    In this regard, at the time of payment of the premium, the insurance company must provide the insured persons with a detail of the modifications to the coverage, so that the insured person may express their conformity with the new terms of the contract.
    Now
    In group or collective insurance, the company must provide sufficient documentation to the policyholder so that the latter makes known to the insured the modifications that have been incorporated into the contract, in accordance with the provisions of the preceding paragraph.
  • Deadline
    Before
    Insurance companies that commercialize microinsurance must submit to the Superintendencia, on a quarterly basis, on the dates for submission of financial information, the annexes indicated below and which form part of this Reglamento:
    Now
    Companies must submit the information required in Annex No. ES–16 “Information on current microinsurance policies” on a semi-annual basis.
  • Who is bound
    Before
    Companies are responsible for ensuring that, in cases of insurance with death or accidental death coverage, the marketer gives immediate notice, in cases where it becomes aware of the death of any of the insured persons.
    Now
    Companies must comply with the following obligations for the sale of microinsurance through marketers, and incorporate them into the corresponding marketing contract: f) In cases of insurance with death or accidental death coverage, the marketer must immediately notify the company, in cases where it becomes aware of the death of any of the insured.
  • Deadline
    Before
    e) Term for payment of the benefit.
    Now
    Companies must train their marketers on the conditions and characteristics of the microinsurances they are going to market, so that they can adequately inform potential policyholders and/or insured about the following aspects: e) Deadline and procedure for the payment of the indemnity.
  • Scope
    Before
    f) Procedure for handling claims.
    Now
    Companies must train their marketers on the conditions and characteristics of the microinsurances they are going to market, so that they can adequately inform potential policyholders and/or insured about the following aspects: f) Procedure for handling inquiries and claims.
  • Who is bound
    Before
    l) Upon the occurrence of the claim, the coverage request must be submitted to the insurance marketer, who shall process the payment of the corresponding indemnity before the insurance company directly or through the insurance broker.
    Now
    To proceed with the payment of the indemnity, the insured party or the beneficiary must submit a coverage request, attaching the corresponding documentation, directly to the company, the insurance broker or the marketer, if so established in the marketing contract, so that the payment of the corresponding indemnity is processed.
  • Deadline
    Before
    m) Payment of the indemnity shall be due within ten (10) days of receipt of the supporting documentation indicated in the application-certificate or in the simplified policy, which must refer only to verification of the occurrence of the covered claim.
    Now
    The company is obligated to make the payment of the indemnity within a maximum term of twenty (20) days, counted from the date on which it has received the complete information and/or documentation, directly or through a marketer or insurance broker, indicated in the microinsurance application-certificate or in the simplified policy, which must refer solely to the verification of the occurrence o…
  • Who is bound
    Before
    n) Payment of the indemnity by the insurance company may be made through the marketer or directly to the insured.
    Now
    The payment of indemnities charged to the companies may be made through the marketer or directly to the insured or beneficiary, it being understood in the latter case that the indemnity is considered paid when it is made available to them, communicating the form and/or place where the payment will be made effective; such communication may be made in accordance with the provisions of article 11 of…
New in this text (64)
  • Microinsurance is the insurance to which low-income individuals and/or microentrepreneurs may have access to cover personal and/or property risks, through proportional premium payments in accordance with the risks covered by the policy, under the individual insurance or group or collective insuranc… c) The monthly premium does not exceed 0.60% of the Tax Unit (UIT).
  • In no case may the companies charge the policyholders additional charges to the amount of the commercial premium that are related to the coverage subject matter of the contract, as informed and agreed with the policyholder and/or the insured.
  • The companies are not responsible for losses occurring during the period in which the coverage is suspended.
  • Likewise, the conditions for the reinstatement of coverage in the event of automatic suspension must be indicated in the simplified policy or in the microinsurance request-certificate, which proceeds upon payment of the premium agreed to reinstate the microinsurance coverage.
  • It is possible to agree with the policyholder the reinstatement of the microinsurance coverage, without requiring the payment of the outstanding premium corresponding to the period in which the policy remained suspended.
  • Such provisions are not required in the cases of those contracts in which, for the purposes of reinstatement of coverage suspended due to non-payment, payment of the outstanding premium is not required, as indicated in article 5 of this regulation.
  • The conditions of microinsurance policies must be drafted in simple language, and must clearly establish the risks covered, exclusions and other conditions that generate rights and obligations for the policyholders, insured and/or beneficiaries; in a manner that allows their understanding, without containing referrals to clauses and/or agreements not contained in the policies.
  • SUPERINTENDENCY OF BANKING, INSURANCE AND AFP allow verifying that there was an insurance application in between so that the company has issued the respective policy or the microinsurance application-certificate, as applicable.
  • Companies may contemplate as part of the conditions of the microinsurance policy that the insured presents a health declaration, for insurance with health or medical assistance coverages and for life insurance with coverage of death by natural cause.
  • The health declaration must precisely state the information that the company requires to know about the insurable risk, therefore aspects about which the insured was not asked to inform may not be considered as grounds for rejection of the claim.
  • Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: b) Identification and address of the marketer (including bancassurance and electronic money issuing companies), if applicable, and the commission it receives.
  • Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: c) Identification and address of the insurance broker, if applicable, indicating the official registration number of the insurance broker and the commission it receives.
  • Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: f) Identification of the beneficiaries of the insurance, when applicable.
  • Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: g) Date of issuance and validity of the policy.
  • Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: k) Procedure to follow and information that the insured or the beneficiary must present to make the coverage request in case of claim.
  • Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: l) Insurance premium, which includes the commercial premium and taxes.
  • Microinsurance may be contracted under the individual insurance modality through the simplified policy that must contain, at a minimum, the following information: o) Any other determined by this Superintendencia.
  • For these purposes, companies may apply the provisions regulating the use of electronic insurance policies, in accordance with the Market Conduct Management Regulation of the Insurance System, approved by Resolution SBS N° 4143-2019, to the extent applicable.4
  • The marketer and the company are responsible for verifying that the insurance application contains the minimum information required for contracting the microinsurance.
  • The insurance application may form part of the simplified policy and, in this case, the policy must be delivered to the policyholder at the time of contracting the microinsurance.
  • Microinsurance policies contracted under the group or collective insurance modality must consider the minimum information and conditions indicated in the previous article.
  • Companies may agree with the policyholder on the use of direct communication mechanisms, such as communications sent to the physical address, email or by telephone; which must be expressly indicated in the policy.
  • In case of intermediation through an insurance broker, all communications sent to the policyholder and/or the insured must be sent in copy to the insurance broker at the email indicated for such purpose.
  • The lack of express acceptance of the proposed modifications does not result in the termination of the contract, in which case the terms under which the contract was initially agreed must be respected.
  • The microinsurance policy is automatically renewed under the same conditions in force in the previous period, provided that the microinsurance policy contains an automatic renewal clause.
  • The policyholder has a period of no less than thirty (30) days, prior to the expiration of the contract, to express their rejection of the proposal.
  • In the event of the policyholder's rejection of the proposed modifications for renewal, the company may choose not to renew the simplified policy or the microinsurance application-certificate, as applicable, at the end of the corresponding term.
  • For the incorporation of microinsurance policy models into the Registry, companies must submit the following information, through the electronic means determined by the Superintendency5 : a) Model of the simplified policy, in the case of individual insurance, including any additional clauses that form part of it, if applicable, and the model of the insurance application, in case the simplified po…
  • If the marketing of microinsurance is carried out through correspondent tellers of financial system companies (bancassurance) or electronic money issuing companies, the marketing contract must expressly state this, as well as the mechanism used by the parties to have updated information on said tellers, such as their company name and location.
  • Companies that use marketers must comply with the following: a) Develop and implement policies and procedures to select their microinsurance marketers, and must establish evaluation criteria that consider, among others, the following aspects, whenever applicable: i. Financial situation, which includes at a minimum not having been classified as a debtor in the deficient, doubtful or loss categorie…
  • Companies that use marketers must comply with the following: a) Develop and implement policies and procedures to select their microinsurance marketers, and must establish evaluation criteria that consider, among others, the following aspects, whenever applicable: ii. Reputation.
  • Compliance with the requirements defined by the company for the selection of marketers must be monitored periodically.
  • b) Keep at the disposal of the Superintendency the following information regarding each microinsurance marketer: i. Name, denomination or company name, and activities carried out.
  • b) Keep at the disposal of the Superintendency the following information regarding each microinsurance marketer: ii. List of microinsurance and other insurance marketed, indicating the registration code of the Superintendency.
  • b) Keep at the disposal of the Superintendency the following information regarding each microinsurance marketer: iii. Location of the establishments used in the marketing.
  • b) Keep at the disposal of the Superintendency the following information regarding each microinsurance marketer: iv. Marketing contract with the information required by the Superintendency.
  • Companies must comply with the following obligations for the sale of microinsurance through marketers, and incorporate them into the corresponding marketing contract: Likewise, the company must ensure that the marketer keeps control of said payments.
  • Companies must comply with the following obligations for the sale of microinsurance through marketers, and incorporate them into the corresponding marketing contract: e) Prepare a procedure for the collection of premiums, in which the functions and responsibilities of the marketer are defined, as well as the deadlines applicable for providing the company with the information on the sale and colle…
  • Companies must comply with the following obligations for the sale of microinsurance through marketers, and incorporate them into the corresponding marketing contract: g) The deadlines for handling coverage requests, as well as claims submitted, will not be extended with respect to those contemplated in this Regulation, for having been submitted through the marketer, in accordance with the provisi…
  • Companies must comply with the following obligations for the sale of microinsurance through marketers, and incorporate them into the corresponding marketing contract: h) Marketers must keep in their commercial premises information that, visibly to the public, clearly shows their status as marketer with an indication of the corresponding company.
  • The marketing conditions indicated in literals b) and d) must be incorporated into the simplified policy and the microinsurance application-certificate.
  • Companies must train their marketers on the conditions and characteristics of the microinsurances they are going to market, so that they can adequately inform potential policyholders and/or insured about the following aspects: a) Coverages, benefits and exclusions of the microinsurance products.
  • Companies must train their marketers on the conditions and characteristics of the microinsurances they are going to market, so that they can adequately inform potential policyholders and/or insured about the following aspects: b) Procedure for contracting microinsurances.
  • Companies must train their marketers on the conditions and characteristics of the microinsurances they are going to market, so that they can adequately inform potential policyholders and/or insured about the following aspects: c) Payment of the premium and effects of non-compliance.
  • For such purposes, at least one annual training session must be considered, as well as training sessions each time a new microinsurance product is marketed.
  • Likewise, companies must provide their marketers, by physical or electronic means, with documentation or informational brochures that allow potential policyholders and/or insured parties to have clear and complete information on the coverages and main conditions of each microinsurance product offered to them, as well as contact information (website and/or email and/or telephone) or authorized pla…
  • Companies in the financial system and electronic money issuing companies are responsible for ensuring that their correspondent agents market microinsurance products in accordance with the information provided by the companies and in compliance with the conditions set forth in the marketing contract.
  • Companies are responsible for verifying that their marketers provide potential policyholders and/or insured parties with the information and/or documentation on the microinsurances they market.
  • Companies may also use distance marketing systems to promote, offer or market their microinsurance products, subject to the provisions of current regulations, insofar as applicable.
  • Provided that the microinsurances are not a condition for contracting credit operations, the company using the distance marketing system must inform the policyholder or insured party, as applicable, regarding the right of withdrawal to terminate the contract, without stating a cause or any penalty,… a) The policyholder and/or insured party may exercise the right of withdrawal, as long as the cove…
  • Provided that the microinsurances are not a condition for contracting credit operations, the company using the distance marketing system must inform the policyholder or insured party, as applicable, regarding the right of withdrawal to terminate the contract, without stating a cause or any penalty,… b) The term to exercise the right of withdrawal, for microinsurances contracted under the individu…
  • Provided that the microinsurances are not a condition for contracting credit operations, the company using the distance marketing system must inform the policyholder or insured party, as applicable, regarding the right of withdrawal to terminate the contract, without stating a cause or any penalty,… c) The term to exercise the right of withdrawal in the case of microinsurances contracted under th…
  • Provided that the microinsurances are not a condition for contracting credit operations, the company using the distance marketing system must inform the policyholder or insured party, as applicable, regarding the right of withdrawal to terminate the contract, without stating a cause or any penalty,… d) The channels and procedures available to exercise the right of withdrawal before the company.
  • Provided that the microinsurances are not a condition for contracting credit operations, the company using the distance marketing system must inform the policyholder or insured party, as applicable, regarding the right of withdrawal to terminate the contract, without stating a cause or any penalty,… e) If the policyholder or the insured party exercises their right of withdrawal after having paid …
  • Companies must disseminate through their website updated information on the microinsurance products they offer, ordered by risk or by product, indicating the covered risks and applicable exclusions, in addition to attaching the corresponding policy model with its respective identification code in the Registry of Insurance Policy Models and Technical Notes of this Superintendency.
  • In microinsurances for property damages, the policyholder or the insured party shall notify the company of the claim as soon as they become aware of its occurrence and within a term no greater than three (3) days, unless the corresponding policy provides for a longer term.
  • In the case of personal microinsurances, the insured party or the beneficiary, as applicable, must notify the company of the claim within seven (7) days following the date on which they become aware of the occurrence of the claim or of the existence of the benefit, as applicable, unless the policy provides for a longer term.
  • Failure to comply with the aforementioned terms does not constitute grounds for rejection of the claim, if the insured party or the beneficiary proves their lack of fault or that the non-compliance was due to fortuitous event, force majeure or impossibility of fact.
  • In such cases, the insurance broker or the marketer, as applicable, is obligated to forward the coverage request in the event of a claim to the company.
  • In the event of delay in the payment of the indemnity, the company must pay the insured party or beneficiary an annual default interest equivalent to one point five (1.5) times the average rate for active operations in Peru, of the currency in which the insurance contract is expressed, for the entire time of the delay.

The first 60 of 64 are shown.

Not carried over (24)
  • Microinsurance products must comply with the following characteristics: a) They respond to the risk profile and protection needs of a specific identified insurable group, and when applicable they must indicate the marketer.
  • Microinsurance products must comply with the following characteristics: b) The coverages must be adequate to the characteristics of the sector to whom they are directed and consider their real and immediate protection needs.
  • Microinsurance products must comply with the following characteristics: c) The simplified policy and the application-certificate must be drafted in simple language and contain the minimum requirements established in numeral 6 of this Regulation.
  • Microinsurance products must comply with the following characteristics: d) The group insurance policy must be drafted in easily understandable language, in accordance with the characteristics of the microinsurance, contain the minimum information indicated in numeral 6 of this Regulation, and must not include conditions that affect its characteristics of simplicity, clarity and ease in contractin…
  • In the case of minors, the indemnity must be paid to one of their parents.
  • i) Coverage shall terminate due to non-payment of the premium, payment of the total coverages established in the policy, expiration of the term established in the policy, willful misconduct or fraud by the policyholder or insured, or voluntarily by the insured, with prior notice of thirty (30) days to the insurance company.
  • k) Expenses related to the issuance of the policy must be included within the premium amount.
  • In cases of individual insurance, the marketing contract allows the natural or legal person to market the product, under the terms set forth in numeral 13 of this Regulation.
  • Such documents must bear the signature of the representative of the insurance company or marketer, respectively.
  • d) Procedure for requesting payment of the benefit.
  • The insurance application of the simplified policy as well as the application-certificate must be duly signed by each insured.
  • Likewise, they must be registered in the Registro de Pólizas de Seguro y Notas Técnicas referred to in Resolución SBS N° 1136-2006 and its amendments.
  • Likewise, the insurance company must inform the insured person that, in the event of not accepting the modified conditions of the contract, the coverage will terminate within the period provided in the preceding paragraph or, failing that, when the grace period corresponding to the moment in which the insured person stops paying the premium expires.
  • When the policyholder of the insurance is an entity supervised by the Superintendencia, it must inform its clients or associates when a credit operation is linked to a microinsurance, so that the insured persons become aware of the need to contract the corresponding coverage.
  • If the claim persists or if they do not agree with the responses provided by the company, the insured persons may choose the dispute resolution mechanisms they consider appropriate, in accordance with the current regulatory framework.
  • Arbitration as a means of dispute resolution shall be considered in cases that do not restrict the rights of the insured person.
  • The commercialization contract entered into by the insurance company with natural or legal persons acting as commercializers must contain at least the following: e) The specific detail of the microinsurance products subject to commercialization, which must be defined and developed in the terms indicated in this Reglamento.
  • The commercialization contract entered into by the insurance company with natural or legal persons acting as commercializers must contain at least the following: f) The commitment by the insurance company to adequately guide the commercializer's personnel on the microinsurance contracting procedure.
  • The commercialization contract entered into by the insurance company with natural or legal persons acting as commercializers must contain at least the following: g) The commercializer's commitment to distribute among potential insured persons the informational brochures for the microinsurance products provided by the insurance company, so that they have appropriate knowledge of the insurance offe…
  • The insurance company must ensure that the insured person has information on the identification of the insurance company providing the coverage and the address and contact telephone number for the attention of coverage requests and answering queries.
  • In the case of insurance intermediated by insurance brokers, they must permanently advise the policyholder on the scope of coverage in accordance with the regulations governing their activity.
  • a) The provisions of Articles 6, 7, 8 and 9 of the Insurance Policy and Technical Notes Regulation, approved by SBS Resolution No. 1420-2005, and its amending rules, are not applicable to microinsurance policies.
  • - Fail to comply with the terms established in the policies or certificate or application, in accordance with the regulatory framework for the payment of the indemnity owed to the insured or the insurance beneficiary.
  • [1] The information in this annex must match that presented according to the Insurance Policy and Technical Notes Registry Regulation and its amendments.

“Not carried over” means the sentence has no counterpart in this text; the rule can still be in force in another text.

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