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10 Insurance Act - 240228 - 181921
10 Insurance Act - 240228 - 181921
INSURANCE ACT
1. Basic Understanding:
Insurer: means a corporate body registered to undertake insurance business and it includes the re-insurer.
Insured: a person or organization holding a Life Insurance and Non-Life Insurance Policy.
Insurance Policy means a document mentioning the rights and liabilities relating to the contract of the Insurance.
Insurer Insured
An insurance premium is the amount of money an individual or business pays for an insurance policy.
Insurance Contract (Section 62) Vs. Insurance Policy (Section 63): An insurance policy is simply a narration of terms and conditions which
do not attach to a particular person, item or interest. By contrast, an insurance contract creates contractual obligations between the parties.
Section 64: Insurer shall not accept insurance risk and issue insurance policy without receiving all insurance premium.
Exceptions: Bank Guarantee (of > 30 days) or Guarantee by GoN
Insurance Business (Section 61) = Life Insurance Business + Non-Life Insurance Business (Including re-insurance)
Life Insurance Non-Life Insurance Re-Insurance
Business relating to a contract regarding to the life of any person under Other Insurance Business Re-insuring the portion of the
which he/she or his/her heir in the event of his/her death, will be paid a other than the Life risk, which is excess of the
particular amount in case a specified amount is paid in installment on the Insurance Business. risk to be hold by the Insurer.
basis of his/her age.
As on March 2023: 18 As on March 2023: 18 As on March 2023: 2
Substantial Shareholders: means any natural person, company or entity with 1 % or more of the paid up capital.
Insurance Mediators: Insurance agents, insurance surveyors, insurance brokers, third party insurance facilitators or others as prescribed,
Actuary: Person having the qualification as prescribed from recognized institutions and is appointed by the Insurer for assessing and
calculating the liabilities of the Insurance Business.
As per Non-Life and Re-Insurance Business Directives:
Actuary means a fellow member of any of the following professional bodies:
Institute and Faculty Institute of Casualty Actuarial Canadian Institute Institute of Other professional
of Actuaries, U.K Actuaries of India Society, USA of Actuaries Actuaries of body recognized by
Australia Beema Samiti
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up to the fiscal year immediately preceding for making of application pursuant to this Section,
f) If application is made by any corporate body following details:
i. Copy of board's decision of the corporate body to incorporate insurance company,
ii. Memorandum of Association and Articles of Association of the concerned company,
iii. Documents proving capacity to make investments,
iv. If such corporate body is undertaking the type of business that requires regulation from any regulatory body
as per prevailing laws, copy of permission granted by such regulatory body to make investment in
insurance business.
g) Other details or documents as specified
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Notes:
i. NIA shall not grant prior approval to undertake more than one insurance business at a time except re-insurance business.
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i. If the following persons and the firms or companies having substantial ownership of
such person and of the member of their family had been punished in:
a) Regulatory actions of NRB,
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Domestic
a) Prior approval granted by the Authority to incorporate insurance company,
b) Registration Certificate of the incorporated insurance company,
c) Copy of memorandum of association and articles of association of the insurance company,
d) If promoter of insurance company is any company or corporate body, copy of previous three year's
audited financial statements and evidence of tax clearance,
e) If promoter of insurance company is any company or corporate body, name of substantial shareholders
and details about their family members,
f) The type of insurance business to be undertaken by the insurance company,
Inform the applicant
Notes:
i. NIA shall clearly specify the type of insurance business that can be undertaken by the insurer.
ii. NIA may, while granting license for carrying on insurance transactions, specify necessary terms and conditions by giving consideration
to existing position of the insurance company, healthy operation of insurance transaction and interests of insured and it shall be the
duty of concerned to comply with terms & conditions.
iii. In case the NIA has specified the date of enforcement of license while issuing license to carry on insurance business, the license shall
be deemed to have been activated from that specified date & if no such date has been specified, the license shall be deemed to have
been activated from the date of issuance of the license.
iv. License is non-transferable.
v. Commencement of Insurance Business (Section 30):
Commence its insurance business: Within 6 months from the date of obtaining the license.
If cannot commence: Submit an application along with reasons, to NIA, before the expiry of such period for extension.
Extension may be granted, if satisfied: Further 6 months & commence within extended 6 months
If cannot commence: License to be cancelled.
vi. The insurer may, by obtaining prior approval from NIA open branch in Nepal or outside Nepal as prescribed. (Section 32)
vii. Any foreign insurer may, by obtaining prior approval from NIA, open liaison (Contact) office in Nepal, within the purview relevant
acts. Such liaison office shall not undertake insurance business. (Section 33)
viii. Insurer may make an application to the NIA for voluntary cancellation of license. (Section 34)
ix. Net Assets of insurer shall be more than net liabilities i.e. Positive Net worth & Solvency Margin (Ratio of net assets to net liabilities)
of insurer shall be as prescribed by NIA. (Section 42)
x. The insurer shall, within 1 year of obtaining license, appoint or specify a compliance officer, form officer graded employees who had
obtained master's degree in insurance or management or commerce or law, and provide information of such appointment to the Nepal
Insurance Authority. The insurer who had already obtained license at the time of commencement of this act shall, within six months
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of commencement of this act, appoint or specify a compliance officer as per this act and provide information of such appointment to
the Nepal Insurance Authority. (Section 70)
xi. Foreign Insurance Company shall, while selling or pledging any immovable assets located in Nepal or while selling or pledging any
movable assets more than the prescribed limits or while taking back such assets to foreign country, obtain approval from the Nepal
Insurance Authority in addition to the approval to be obtained as per prevailing acts. (Section 74)
12. An insurance company shall not carry out or cause to carry out the following activities: (Section 69)
a) Purchase or sell moveable or immovable assets in excess of the limit prescribed by the Nepal Insurance Authority,
b) Provide loan or any kind of guarantee or security in loans taken to its director, director's family members, substantial shareholders,
chief executive officer, any firm, company or corporate body in which the insurer or its director is managing agent or partner,
c) Provide any type of loan to insured except on security of life insurance policy,
However this provisions shall not restrict the insurer to provide loan or advance to its employees as per the provisions of employee
services, terms and conditions and facilities bylaws.
d) Issue insurance policy in any format other than the format prescribed by the Nepal Insurance Authority,
e) Calculate and make assessment of insurance tariffs contrary to the insurance tariffs prescribed by the Nepal Insurance Authority,
f) Calculate insurance premium in contrary to insurance tariff prescribed the Authority,
g) Make investment in shares or securities of another insurance company undertaking same type of insurance business or making
investment in insurance brokers,
However this provisions shall not restrict the insurer to make investment in shares or securities of another insurance company
undertaking different type of insurance business, by obtaining prior approval of the Nepal Insurance Authority.
h) Make any type of investment in any company, firm or corporate body in which any of the director of insurer is holding position of
director or in any in any company, firm or corporate body in which any of the director have personal, financial or occupational interest,
i) Indulging in any kind of activities to mutually create any type of monopoly or any other type of activities that may create control in
insurance business,
j) Doing or causing other to do any kind of act which that may create an artificial obstruction in the competitive environment of the
insurance or any activities that may create controlled practice in the insurance business,
k) Doing such other acts or causing others to do any such acts prohibited from being done as per this act or rules and regulations made
hereunder or directives issued by the Nepal Insurance Authority.
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Notes:
i. The above provisions shall not be applicable to insurance companies incorporated with ownership of GoN or Provincial
Government.
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21. Provision on Sale or Pledging of Securities by promoters (Promoter share lock-in period) (Section 46)
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e) An incumbent/serving Director or an employee of any corporate body carrying out transactions of insurance or banking or
financial transactions or any institution collecting any type of deposits or incumbent (existing) director with substantial
shareholding of promoter's group or incumbent employee of any other insurance company, carrying out transactions relating to
insurance,
f) An incumbent auditor or an advisor of the concerned insurance company or a person, firm or company who/which is a partner in
any kind of contract with the concerned insurance company or having personal interests,
g) Who has acquired the membership of the Stock Exchange to act as a securities broker or a merchant banker,
h) Incumbent Director of another insurance company,
i) A person, who has not subscribed to the minimum number of shares required to subscribe to be eligible for appointment as a
Director pursuant to the Articles of Association of the insurance company,
j) A person who is has not subscribed the qualification shares required to hold the position of director,
k) A person holding any constitutional post or incumbent employee of the Government of Nepal, or a corporate body having
ownership of the Government of Nepal, or the Nepal Insurance Authority or of any insurance company or bank or financial
institution,
Provided that nothing in this clause shall prevent from nominating a Director in a different category of insurance company of
which share has been purchased by the Government of Nepal or an institution having under the ownership of the Government of
Nepal or insurance company,
l) Who, having a liability to pay taxes pursuant to the laws in force, has failed to pay,
m) If he or she has not completed a period of five years after serving out the sentence upon being convicted of an offence of theft,
cheating, forgery, fraud, corruption, any offence involving moral turpitude or offence related to insurance or banking or money
laundering from a court of Nepal or that of a foreign country,
n) If action had been taken against him or her by a regulatory agency as per the law for committing an act in contravention of the
law and if he or she has not completed a period of five years after being taken such action,
o) If he or she has not served the full sentence or is yet to clear the dues of the fine imposed by a court of law or if he or she is in
arrears to pay a government due.
p) If he or she has not completed a period of three years after serving out the sentence provided by the Nepal Insurance Authority
due to non-compliance of directions of the Authority.
Discontinue to hold office (Section 51)
a) If he or she is disqualified pursuant to Section 50,
b) In cases where a motion to remove from the office of a Director is adopted by a majority of the General Meeting at the
recommendation of the group from which he/she was appointed to the office of Director that is passed by the shareholders having
representation of at least fifty-one percent of the shares of the same group,
Explanation: For the purpose of this Section, “group” means a group of promoters and shareholders from the general public.
c) If the resignation tendered by a Director from his/her position is approved,
d) If the Nepal Insurance Authority directs to remove such person from the office stating that since he or she carried out activities
against the rights and interests of insurer or insured.
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However, this clause shall not be applicable for appointment of chief executive officer of
foreign insurer or insurance company in joint investment with foreign insurer,
If he or she has been convicted for an offence of theft, cheating, forgery, fraud, corruption,
any offence involving moral turpitude or offence related to insurance or banking or money
laundering,
l) Holding any constitutional post.
Functions, duties and powers:
a) Implement the decisions of the Board and supervise and control the activities and transactions of the insurance company, subject
to this Act and the memorandum of association and articles of association;
b) Prepare annual budgets and action plans of insurance company and present them before the Board for approval;
c) Manage necessary human resources, subject to the personnel bye-laws of the insurance company;
d) Implement, or cause to be implemented, the decisions of the Board and the General Meetings;
e) Operate the insurance company as per this act and directions of the Nepal Insurance Authority and ensure efficient internal control
system and risk management in the insurance company;
f) Present on time all such particulars, documents, decisions, etc. as are required to be submitted by the insurance company to the
Nepal Insurance Authority or any other body, subject to this Act and the memorandum of association and articles of association.
24. Books of accounts & audit of insurance companies (Section 83 - 89)
Submit to authority quarterly: within 30 days of each quarter
Publish: Quarterly
Submit Audited F.S.: within 6 months of expiry of F. Y.
Appoint auditor as per prevailing laws.
Any of the following persons shall not be appointed as an auditor of insurance company:
a) Substantial shareholder, director or his/her close relative,
b) Chief Executive Officer or his/her close relative,
c) Insurance Mediator of the insurer , employees or his/her family member belonging to same family,
d) In case of ex-employee, if three years had not expired after leaving from the office,
e) A person working as a partner of any director or chief executive officer or employee of the insurer,
f) A person with financial interest with the insurer or his/her family member belonging to same family,
g) The insured who had undertaken insurance form the insurer in the amount exceeding the prescribed limit,
h) A person who had been appointed as auditor of the concerned insurer for consecutive three years,
i) Member of board of Nepal Insurance Authority, incumbent employee of the Nepal Insurance Authority or their partner or their
family member,
j) A person, who is disqualified to be appointed as auditor or disqualified to continue to hold office as auditor as per prevailing
laws.
Audit: within 3 months of expiry of F. Y., further 2 months extension if required
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Within 30 days of completion of its audit, submit its financial statements to NIA for approval.
Publish its audited financial statements at least twice in National Level communication means and also make public in its website.
Upon receipt of the audit report, the NIA may, if deemed necessary, order the auditor of the insurance company to carry out the
following additional functions:
a) To submit additional information as required by the NIA,
b) To carry out other tests on specific matter as directed by NIA or on matters recommended to the insurance company by NIA.
The NIA shall write to the concerned regulating authority to remove name of an auditor, who does not perform his/her duties as per
this Act, from the panel of the auditors to prohibit him/her to carry out audit of any insurance company for 1 - 3 years.
25. Insurance mediators: Insurance agents, insurance surveyors, insurance brokers, 3rd party insurance facilitators (Section 90 -
97)
Submit application to NIA for license.
Before acquiring license, pass the prescribed examination.
While granting license of Insurance Surveyor under non-life insurance, license shall be issued to conduct survey of one type of
insurance (Portfolio) only.
(The insurance surveyor shall not evaluate or conduct survey or cause to evaluate the loss of its close relatives or firms or companies
where its family members belonging to same family or their close relatives have financial interest.)
While granting license of Insurance Agents, license shall be issued to work as Insurance Agent of only one insurer of same kind.
Agent undertaking activities related to micro insurance may work for more than one insurer undertaking micro insurance business.
License cannot be used by or transferred to others.
If any insurer had engaged in its work any Insurance Mediator or Other Insurance Service Provider without license or whose license
has been cancelled, all consequences and liabilities that may arise shall be borne by the concerned insurer itself.
The license of insurance brokers or third party insurance facilitators shall be granted only to the following corporate bodies incorporated
as per prevailing laws:
a) With the authorized capital as prescribed by the Nepal Insurance Authority,
b) The person working in the capacity of the General Manager of the corporate body shall have a 4 years’ experience regarding
the Insurance Business,
c) Others as specified by the Nepal Insurance Authority
Validity of license = 3 years, renew before expiry (time limit can be extended up-to further 3 months if reasonable cause produced)
License ipso facto cancelled: if not renewed (OBH to be provided before cancelling)
Cancellation of license by NIA: (OBH to be provided before cancelling)
a) Acted against this act or rules or regulations made under this act or directives or directions provided by NIA, or
b) If it is proved that such Insurance Mediator or Other Insurance Service Provider had acted against the interest of the insured.
26. On liquidation or insolvency of any insurer, liabilities shall be paid in following order (Section 121)
a) Expenses incurred for mandatory liquidation,
b) Amount payable to insured,
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c) Amount payable to government of Nepal as taxes, fees or charges, as per prevailing laws,
d) Amount payable to the Authority as regulatory fees,
e) Remuneration or commission payable to insurance mediators,
f) Amount of insurance payable to other insurers,
g) Salary, allowances, provident fun, gratuity and other amounts payable to employees,
h) Other liabilities undertaken by the insurer,
i) Other amounts payable by the insurer or any other liabilities to be payable,
j) Amount to be obtained by Shareholders.
27. Arbitration function of Insurance Board: (Adjudication/ Arbitration) (Section 128, 129 & 130)
If: If any loss is caused to insured due to:
insurance claim is not assessed within Insurer
time Directors Concerned insurer shall
insured may submit
insurance claim is assessed to the Officials pay compensation.
a complaint to NIA.
disadvantage of insured employees of insurer (Otherwise submit
compensation is not paid Insurance mediators complaint to NIA)
Other insurance service providers
NIA to conduct necessary investigation & provide a reasonable NIA to conduct necessary investigation & provide a reasonable
opportunity to the concerned Insurer to submit clarification within opportunity to the concerned insured, directors, officials,
15 days. employees or concerned insurance mediators to submit
clarification within 7 days.
By accepting the clarifications or if clarifications is not received By accepting the clarifications or if clarifications is not received
within prescribed time, the NIA may: within prescribed time, the NIA may:
a) Make compromise between complainer and insurer, a) Make compromise between complainer and insurer,
b) In case any loss or damages was caused to the insured due to b) Order make payment of reasonable amount as compensation
not making payment of claims, order to pay such compensation for loss or damages, so sustained if, any
of such losses or damages sustained,
(Pay compensation along with interest @ 10 % from the day of
complaint & all the expense incurred for such legal remedy
shall be compensated by the concerned insurer.)
c) If the liability for compensation determined by the insurer is
not found to be reasonable, order to re-determine such liability,
d) Order the concerned insurer to pay compensation to the
insured, if payment of compensation is to be done,
e) Issue any other appropriate orders.
Unsatisfied party may file an appeal to high court within 35 days.
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(Such removed person shall not get any compensation or facilities in case of retirement
also and such person shall not be eligible to be appointed in any insurer till five years of
such retirement.)
d) If it is found that any person had provided or received remunerations or allowances or any
other facilities in contravention of this this act or rules made hereunder this act or
regulations, by-laws or directions or orders, recover such amount along with interest as
per prevailing laws from the person providing such facilities,
e) Order the concerned insurer to write to the concerned authority where the directors,
officials, chief executive officer or employees of insurer are involved professionally.
If any insurer is required to make any payment to any person due to negligence or mistakes or recklessness of any directors, officials, chief executive
officer or employee, the Nepal Insurance Authority shall order to recover or cause to recover such expenses from the concerned and such person shall
make payment within 35 days.
If such concerned do not make payment NIA, may recover such amount from the bank accounts or moveable or immoveable assets of the concerned
or his family members.
30. Suspension of license or ban entirely or partially to conduct any type of business being operated (Section 135 & 136)
NIA may suspend the license of insurer for prescribed period or impose a ban entirely or partially to conduct any type of business being
operated by the Insurer under any of the following circumstances:
a) Minimum paid up capital not maintained,
b) Decisions made for payment of insurance compensation not implemented within prescribed time or does not make payment,
c) Situation arises that may cause serious damages to insured if insurance business is being operated,
d) Insurance business is liquidated i.e. closed without the approval of NIA,
e) Any activities or acts are carried out in contravention of this act or rules made hereunder or regulations, by-laws or other
prevailing laws,
f) Directions or orders from NIA not complied time and again.
Before suspending or imposing a ban, NIA, shall provide a reasonable time-limit to submit clarification to the concerned Insurer clearly
stating the reasons for imposing the ban on its Insurance Business by publishing a notice in two major newspapers and also in its
website for the information of public in general.
If submitted clarifications are found to be satisfactory, NIA may remove such suspension or lift such ban.
31. Cancellation of registration (Section 137)
NIA may cancel the registration of an Insurer in the following circumstances:
a) If the Insurer is banned and such ban could not be lifted until 1 year of such ban,
(An opportunity to rectify may be provided once.)
b) If there occurs situation that may cause serious damages to insured if insurance business is being operated,
(An opportunity to rectify may be provided once.)
c) If court initiates insolvency proceedings of such insurer as per prevailing laws,
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d) On receipt of application of cancellation of license, the process of cancellation of license had been completed.
Before canceling the registration, NIA, shall provide a reasonable time-limit to submit clarification to the concerned Insurer clearly
stating the reasons for imposing the ban on its Insurance Business by publishing a notice in two major newspapers and also in its
website for the information of public in general.
On cancellation of registration, settlement of liabilities shall be done as prescribed.
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d) If any insured receives insurance claims by forgery or preparing or not preparing any false
documents or reports, with our without in collaboration with insurance mediators or other
insurance service providers or other parties,
e) If any surveyor had conducted assessment of insurance loss and prepared false survey Recovery/Forfeit: Amount in question and
report (i.e. over-valued or under-valued) with malafide intention and caused losses or Amount in question Imprisonment
damages to insurer or insured, Up to 10,00,000.00 Up to 1 year
f) If any insurance agent , with malafide intention, embezzles money received as insurance More than 10,00,000.00 Up to 2 years
premium (i.e. charges or fess) without giving such amount to insurer, to 50,00,000.00
g) If any employees or officials or other persons related to insurer causes any irregularities or More than 50,00,000.00 Up to 3 years
financial abuse while issue insurance contract or conducting assessment of losses or making to 1,00,00,000.00
payment of insurance claims or any activities while conducting insurance business, More than 3 years – 5 years
h) If any director or officials or employees or chief executive officer or other person causes 1,00,00,000.00
any irregularities while merger or acquisition or liquidation or auditing of any insurer,
i) Any person abets to conduct offence as per clause (a) to (h). Half the punishment imposed to main offender
If any officials or employees of foreign insurer except in the course of ordinary transactions of Fine: Amount in question and
operation of branch, is found out that assets of such branch had been transferred to another Imprisonment: Up to 5 years
country without obtaining permission from the Authority or permission had been obtained by
submitting false documents or had given authority for such transfer or abets such transfer, the
person doing such is deemed to have committed an offence under this act.
If amount in question could not be determined: on the basis of gravity of offence,
Fine: Up to Rs. 10,00,000.00 and
Imprisonment: Up to 2 years
If the offence to be punishable by this section is committed by corporate body, the director, chief executive officer, office-bearer or employee of such
corporate shall be liable to punishment.
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If special administration group is convinced that the controlled insurer is recovered and can operate properly it can carry out following
actions: (Section 108)
a) Release the suspension order of suspended board of directors,
b) Assign the management and operation of transaction to the board of directors,
c) Form a new board of director from among the shareholders and order to call general meeting of the shareholders within six months,
d) Call the general meeting of the shareholders of such insurer to elect the new board of directors.
If special administration group is convinced that the controlled insurer is not recovered, it can carry out following actions: (Section
109)
a) Auction sale the forfeited shares within prescribed time and transfer them,
b) Recommend the Authority for merger of such insurer with another insurer within prescribed time,
c) Recommend the Authority for cancellation of license of such insurer after transferring business operated by such insurer to another insurer,
d) Recommend the Authority for corrective actions pursuant to section 110,
e) Recommend the Authority for initiation of insolvency proceedings of such insurer.
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40. Under following circumstances, with substantial evidences and basis, the Nepal Insurance Authority, may initiate the process of
liquidation proceedings: (Section 119)
a) The liabilities of insurer is more than assets of such insurer for continuous three years,
b) Unable to make payment of liabilities of which had already been matured or any liabilities that need to be paid immediately,
c) If decision to initiate liquidation proceedings pursuant to clause (e) of section 109 had been made,
d) If it is found that insurer, its directors or chief executive officer had worked against the interest of insured and it is seen that the directions provided
by the Authority for correction had not been complied time and again,
e) The capital fund of insurer is negative for continuous three years,
f) The license of insurer is cancelled pursuant to section 137,
g) The insurer made an application for liquidation pursuant to section 117.
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