IRDAI circular · 10 Jan 2023
सर्वे नं.-115/1, फाइनंशियल डिस्ट्रिक्ट, नानकरामगुिा, Sy No. 115/1, Financial District, Nanakramguda, गच्चीबाउली ,हैदराबाद – 500032, भारत Gachibowli, Hyderabad – 500032, India दूरभाष- 91-040-2020 4000 Ph. : 91-040-2020 4000 Cir. No: IRDAI/ACTL/CIR/MISC/4/1/2023 Date: 10th January, 2023 To All Life Insurers/General Insur…
[Image omitted. See the official document.]
[Image omitted. See the official document.]
Cir. No: IRDAI/ACTL/CIR/MISC/4/1/2023
Date: 10th January, 2023
To
All Life Insurers/General Insurers/Standalone Health Insurers/Reinsurers
Sub: IRDAI (Appointed Actuary) Regulations, 2022
This circular is issued in exercise of the powers conferred under Regulation 12 of IRDAI (Appointed Actuary) Regulations, 2022 and under Section 14(2)(e) of IRDAI Act, 1999.
This circular comes into force with immediate effect.
This is issued with approval of the Competent Authority.
SHYAMA PRASAD CHAKRABORTY
Digitally signed by SHYAMA PRASAD CHAKRABORTY
S.P. Chakraborty
Chief General Manager (Actuarial)
सर्वे नं.-115/1, फाइनेंशियल डिस्ट्रिक्ट, नानकरामगुड़ा,
गच्चीबाउली ,हैदराबाद -500032, भारत
दूरभाष- 91-040-2020 4000
Sy No. 115/1, Financial District, Nanakramguda,
Gachibowli, Hyderabad - 500032, India
Ph. : 91-040-2020 4000
Annexure -1 to Cir. No. IRDAI/ACTL/CIR/MISC/4/1/2023 dated 10.01.2023
Form IRDAI-AA-2
Particulars of applicant Actuary:
(a)Total Relevant Experience
| Sl. No. | Details of the Organization | Designation | From (DD/MM/YYYY) | To (DD/MM/YYYY) | Duration (in months) | Details of Experience* |
|---|---|---|---|---|---|---|
| 1 | ||||||
| … | ||||||
| Total |
(*Clearly indicate the experience in the respective area of Life/Health/General)
(b) Post Fellowship Experience (out of (a) above)
| Sl. No. | Details of the Organization | Designation | From (DD/MM/YYYY) | To (DD/MM/YYYY) | Duration (in months) | Details of Experience* |
|---|---|---|---|---|---|---|
| 1 | ||||||
| … | ||||||
| Total |
(*For the purpose of 3(B)(iii)(b)/ 3(B)(iv)(b)/3(B)(v)(b)- clearly indicate the experience: Annual statutory valuation/Product pricing / Peer Reviewer/Independent Actuary / Panel Actuary /Certifying Actuary /Actuarial consultancy/relevant experience with the Authority in the respective area of Life/Health/General)
(c) Middle/Senior level Management Experience
| Sl. No. | Details of the Organization | Designation | From (DD/MM/YYYY) | To (DD/MM/YYYY) | Duration (in months) | Details of Experience |
|---|---|---|---|---|---|---|
| 1 | ||||||
| … | ||||||
| Total |
Achievements and special positions held presently or previously:
Names, countries of incorporation, addresses and principal activities of any other firms or companies in which the applicant currently is or previously was a Director, Partner, Proprietor, Employee, Consultant, Peer Reviewer, Independent Actuary on with profit committee, Mentor to Appointed Actuary, Panel Actuary or Certifying Actuary of Reinsurance returns
| Sl. No. | Details of the Organization (Name, country of incorporation etc...) | Designation | From | To | Duration (in months) | Work Profile |
|---|---|---|---|---|---|---|
| 1 | ||||||
| … | ||||||
| Total |
Particulars of any criminal conviction for offences in India or elsewhere:
Has the applicant been adjudicated bankrupt during the last ten years? If so, give details:
Has any disciplinary action been taken or initiated by any professional body or any insurance regulator or any other entity? If so give details (Refer Reg. 3(B)(vii)):
Declaration regarding conflict of interest as per Regulation 9 and Regulation 10(d) of Insurance Regulatory and Development Authority of India (Appointed Actuary) Regulations, 2022:
I shall function in accordance with Insurance Regulatory and Development Authority of India (Appointed Actuary) Regulations, 2022 and I shall not function in any other capacity which could result in conflict of interest in performing my role as Appointed Actuary in accordance with these Regulations.
Certification by the Applicant Actuary:
I ……. (Name of the Actuary), hereby certify that the information & declaration given in this form is complete, true and correct. I am also enclosing self-attested copies of the following documents:
Place:
Date:
Signature of Actuary
Certification by the Principal Officer/CEO of the insurer:
Based on the information provided by the proposed applicant Actuary, I……(Name), the Principal Officer/CEO of the ………(Name of the Insurer), hereby certify that *