Lima, 29 October 2009

S.B.S. Resolution No. 14283 -2009

The Superintendent of Banking, Insurance and Private Administrators of Pension Funds

WHEREAS:

That, in accordance with article 345 of the General Law of the Financial System and the Insurance System and Organic Law of the Superintendency of Banking and Insurance, Law No. 26702 and its amendments, hereinafter General Law, it is the purpose of the Superintendency to protect the interests of the public in the field of the financial and insurance systems;

That, for the economic and social development of the country, it is necessary that the less favored sectors can access the benefits of insurance in order to guarantee the continuity of their activities and the protection of their families;

That, by SBS Resolution No. 215-2007 the Microinsurance Regulation was approved with the purpose of establishing conditions for the adequate use of insurance in order to increase its penetration and development in said sectors;

That, this Superintendency has considered it necessary to amend the aforementioned Regulation in order to continue improving the regulatory framework applicable to this type of insurance;

Having regard to the opinion of the Deputy Superintendencies of Banking and Microfinance, of Insurance, of Risks, of Economic Studies and of Legal Counsel and of the Management of Products and Services to the User; and, having complied with the period of dissemination of the draft legal norms of a general nature referred to in article 14 of the Regulation that establishes provisions relating to publicity, publication of regulatory drafts and dissemination of legal norms of a general nature, approved by Supreme Decree No. 001-2009-JUS; and,

In use of the powers conferred by numerals 2, 7 and 9 of article 349 of the General Law;

RESOLVES:

Article One.- To approve the Microinsurance Regulation, applicable to the insurance companies indicated in article 16 literal d) of the General Law, as indicated below

MICROINSURANCE REGULATION

1. Definitions

For purposes of this Regulation, the following definitions must be considered

a) Marketer: Natural or legal person, with which the insurance company has entered into a marketing contract for the purpose of marketing individual or group microinsurance, in accordance with the conditions indicated in said contract.

b) Days: Calendar days

c) Simplified policy: Document that accredits the contracting of the individual insurance. It incorporates the insurance application.

d) Claim: Communication by means of which a user expresses their dissatisfaction with the service and/or product received or manifesting the presumed impairment of a legitimate interest. Likewise, any reiteration that originates as a consequence of the user's disagreement regarding the response issued by the supervised company, or due to the delay, in the attention of the request, query or claim, is also considered.

e) Group insurance: Modality of contracting of insurance, which grants coverage, through a single contract, to multiple insured persons who make up a homogeneous collectivity.

f) Individual insurance: Modality of contracting by means of which coverage is granted through a simplified policy issued by the insurance company.

g) Application-Certificate: Document that accredits the contracting of a group policy.

h) Coverage request: Request for coverage made before the insurance company for the occurrence of a loss.

i) Superintendency: Superintendency of Banking, Insurance and Private Administrators of Pension Funds.

2. Concept

Microinsurance is an insurance that provides protection to the low-income population, against the occurrence of losses derived from human or property risks, that affect them.

The coverage is granted by an insurance company authorized by the Superintendency and contracted under the modality of individual insurance or group insurance, for which the simplified policy or the application-certificate is issued, respectively.

3. Characteristics of microinsurance

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.

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.

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.

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 contracting.

e) Parties involved in microinsurance:

e.1) The insurer is an insurance company authorized by the Superintendency. e.2) The policyholder in the case of an individual insurance, is the insured person themselves or a third party, and in the case of group insurance it is the marketer - natural or legal person - that signs the microinsurance contract.

e.3) The insured is a natural person or a legal person.

e.4) The beneficiary is the insured person themselves or the policyholder. For death coverage, the beneficiaries will be those designated by the insured in the application-certificate or in the simplified policy; and in their absence, they will be the heirs of the insured instituted in accordance with Law, in equal parts. In the case of minors, the indemnity must be paid to one of their parents.

f) No prior verifications may be established in relation to insurable persons and property, unless the nature of the insurance requires them to be established, it being sufficient for the insured to sign the application-certificate or the simplified policy for coverage to take effect. If such verifications are necessary, they must be consistent with the coverages granted in the microinsurance.

g) Exclusions must not be established and, if required, they must be minimal and consistent with the coverages granted by the microinsurance.

h) Payment of the premium shall be made in the form and term established in the simplified policy or the application-certificate. The insured's failure to pay shall determine the suspension of coverage or the termination of the contract, a situation that must be clearly established in the simplified policy or in the application-certificate.

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.

j) Deductibles, copayments and franchises are not applicable.

k) Expenses related to the issuance of the policy must be included within the premium amount.

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.

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.

n) Payment of the indemnity by the insurance company may be made through the marketer or directly to the insured.

o) In cases of claims made by insureds for non-payment of the indemnity, the corresponding procedure must be carried out through the marketer or the insurance broker. For such purposes, insurance companies have a maximum term of fifteen (15) days to resolve the claim submitted.

4. Marketing and product design

Microinsurance shall be marketed directly by the insurance company, by marketers, or through the intermediation of insurance brokers, on the basis of the regulations applicable to the activity of intermediaries.

By virtue of signing the marketing contract, the status of marketer of the insurance company is acquired vis-à-vis the insured.

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.

In group insurance, policyholders of microinsurance policies may take charge of marketing, after signing the contract regulated in the aforementioned numeral.

5. Proof of the microinsurance contract

The existence of the microinsurance contract may be proven by presenting the simplified policy, or the application-certificate signed by the insured. Such documents must bear the signature of the representative of the insurance company or marketer, respectively.

Likewise, the payment receipt showing payment of the premium constitutes means of proof of the contract.

6. Minimum information

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:

a) Identification of the insurance company and of the policyholder.

b) Identification of the insured, with the following minimum information:

b.1) Full name

b.2) Date of birth

b.3) Identity Document

b.4) Home address

c) Detail of the coverages and exclusions of the policy.

d) Procedure for requesting payment of the benefit.

e) Term for payment of the benefit.

f) Procedure for handling claims.

g) Clarification that communications, coverage requests and payments made to the marketer, for the coverages granted, have the same effect as if they had been addressed to the corresponding insurance company.

h) In the case of application-certificates, it must be expressly stated that the insured of a group microinsurance has the right to request a copy of the corresponding policy, including the general, particular, special conditions and additional clauses applicable to them, which shall be delivered by the marketer within a maximum term of fifteen (15) calendar days counted from the date of receipt of the request.

The insurance application of the simplified policy as well as the application-certificate must be duly signed by each insured. 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.

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. Copies of the signed application-certificates must be delivered to the insured at the time of contracting.

7. Registration of microinsurance policies

The microinsurance policy models shall be submitted to the Superintendencia, prior to their commercialization, in accordance with the provisions of article 15 of the Reglamento de Pólizas de Seguro y Notas Técnicas, approved by Resolución SBS N° 1420-2005, and its amendments, indicating in their name that it is a microinsurance. 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.

8. Modification of the microinsurance conditions

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. 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. In the event of the insured person's silence, it shall be understood that they have accepted the new insurance conditions. The insurance company must keep evidence of the communication made.

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.

9. Information on microinsurance to insured persons linked to credit operations

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.

10. Dispute resolution

Insurance companies must address claims arising from a microinsurance operation within a maximum period of fifteen (15) days from their submission by the insured person.

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.

11. Information to the Superintendencia

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:

Anexo ES-161 Statistical information on current Microinsurance policies

12. Requirements of the Commercializer

The commercializer with which the insurance company enters into the commercialization contract must have commercial establishments that provide customer service, with physical infrastructure and adequate human resources for the provision of services under safe conditions.

Microinsurance commercializers may include, among others, companies of the financial system, microfinance institutions, money transfer companies, savings and credit cooperatives not authorized to operate with public funds, companies providing goods or services, public or private institutions, and trade and/or communal and/or social organizations.

13. Commercialization contract

The commercialization contract entered into by the insurance company with natural or legal persons acting as commercializers must contain at least the following:

a) The commercializer's commitment to offer the microinsurance, in strict compliance with the instructions indicated by the insurance company.

b) The commitment that communications and coverage requests submitted by insured persons to the commercializer, on aspects related to the contracted insurance, shall have the same effects as if they had been submitted to the insurance company.

c) The commitment that payments made by insured persons to the commercializer shall be considered as paid to the insurance company.

d) The insurance company's liability for errors or omissions arising from the commercialization of the insurance incurred by the commercializer and for damages that may be caused to insured persons and/or beneficiaries. This is without prejudice to the commercializer's liability vis-à-vis the insurance company.

e) The specific detail of the microinsurance products subject to commercialization, which must be defined and developed in the terms indicated in this Reglamento.

f) The commitment by the insurance company to adequately guide the commercializer's personnel on the microinsurance contracting procedure.

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 offered

14. Liability of the insurance company

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.

[1] Annex numbering modified by Resolución SBS N° 2842-2012 of 11-05-2012.

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.

15. Accounting Provisions

The accounting record of microinsurance premiums must be consistent with the term of the coverage granted.

In the event of non-payment of the premium that extends for more than ninety (90) days with respect to the dates set forth in the policy or application-certificate, insurance companies must provision the entire outstanding amount payable, even if the payment deadline has not yet expired. For such purposes, companies shall apply the provisions of Article 16 of the Premium Payment Regulation approved by SBS Resolution No. 225-2006 and its amendments.

16. Final Provisions

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.

b) The thirty (30) day term established in numeral 4.1 of Circular No. G-110-2003, referring to the User Service, does not apply to the handling of claims originating from a microinsurance.

Article Two.- Make the following amendments to the Sanctions Regulation approved by SBS Resolution No. 816-2005, as indicated below:

a) Incorporate the following infractions in section I of Annex 3 "Specific Infractions of the Insurance System":

Section I: Minor Infractions

• 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.

• Not deliver the application-certificate, in the case of group insurance and/or the simplified policy, in the case of individual insurance, to the marketers, for subsequent delivery to the insured, or deliver it without the minimum information indicated in the Microinsurance Regulation.

Article Three.- The Annex of the Microinsurance Regulation approved by this resolution is published on the electronic Portal of this Superintendency (www.sbs.gob.pe), in accordance with the provisions of Supreme Decree No. 001-2009-JUS.

Article Four.- This Resolution enters into force on the day following its publication in the Official Gazette El Peruano, and repeals the Regulation approved by SBS Resolution No. 215-2007.

Register, communicate and publish.

FELIPE TAM FOX
Superintendent of Banking, Insurance and Private Pension Fund Administrators

ANNEX ES-161

INFORMATION ON MICROINSURANCE POLICIES IN FORCE (1) AS OF ….... /………./ 20……

INSURANCE COMPANY: ................................................................................................

LINE OF BUSINESS	RISK (2) REGISTRATION CODE	COMMERCIAL NAME OF THE PRODUCT	NO. OF INSURED	INSURANCE PREMIUMS (3)	CLAIMS (4)

[1] The information in this annex must match that presented according to the Insurance Policy and Technical Notes Registry Regulation and its amendments.

[2] According to the code of the Concordance Table of Risks of the Chart of Accounts for Insurance System Companies.

[3] Corresponds to account 5001 of the Chart of Accounts for Insurance System Companies.

[4] Corresponds to account 4201 of the Chart of Accounts for Insurance System Companies.

[1] Annex numbering amended by SBS Resolution No. 2842-2012 of 11-05-2012.