THE SCHEDULE
Regulation 10
 
INSURANCE ACT
(CHAPTER 142)
 
INSURANCE (GENERAL PROVISIONS AND EXEMPTIONS FOR MARINE MUTUAL INSURERS)
REGULATIONS
 
FORM 1
 
NAME OF INSURER: __________________________________
 
ANNUAL ANALYSIS OF CALLS, PREMIUMS AND CLAIMS
 
Co Code
 
Year
 
Month
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Source of Business: SIF/OIF*
 
Class of Business: _______________________________________
Policy Year Ended
Row No.
Calls Made/
Refunded in
Financial Year
Anticipated
Future Calls/
Refunds
Reinsurance
Premiums
Paid/Payable
in Financial
Year
Outstanding
Net Claims
Reserve b/f
(including
IBNR)
Net Payments
Made in
Financial Year
Outstanding
Net Claims
Reserve c/f
(including IBNR)
Gross
Payments
Made in
Financial Year
Estimate
of Gross
Payments
Remaining
on Reported
Claims
Estimate
of Gross
Payments
for IBNR
Claims
Month
Year
 
1
2
3
4
5
6
7
8
9
 
 
1
 
 
 
 
 
 
 
 
 
 
 
2
 
 
 
 
 
 
 
 
 
 
 
3
 
 
 
 
 
 
 
 
 
 
 
4
 
 
 
 
 
 
 
 
 
 
 
5
 
 
 
 
 
 
 
 
 
 
 
6
 
 
 
 
 
 
 
 
 
 
 
7
 
 
 
 
 
 
 
 
 
 
 
8
 
 
 
 
 
 
 
 
 
 
 
9
 
 
 
 
 
 
 
 
 
Prior years
10
 
 
 
 
 
 
 
 
 
Total (1 to 10)
11
 
 
 
 
 
 
 
 
 
*Delete whichever is inapplicable.
Premiums in respect of:
 
SIF
OIF
 
Fixed Premium Business:
$_________
$_________
 
INSURANCE ACT
(CHAPTER 142)
INSURANCE
(GENERAL PROVISIONS AND EXEMPTIONS FOR
MARINE MUTUAL INSURERS) REGULATIONS
FORM 2
STATEMENT ON ADEQUACY OF CLAIM LIABILITIES FOR
FINANCIAL YEAR ENDED ___________________
     To the best of my knowledge and belief, I, Chief Executive of _____________________, do state that the amounts of claim liabilities as shown in the books of accounts of the company/branch* and in Form 1 : Fund Balance-Sheet are adequate to meet all ultimate claim payouts under each insurance fund established in accordance with section 17(1) of the Insurance Act (Cap. 142).
     The claim liabilities referred to in this Statement include the expected future payments in relation to all claims incurred prior to the valuation date (other than payments which have fallen due for payment before the valuation date), whether or not they have been reported to the company/branch*, including any expense expected to be incurred in settling those claims and any provision for any adverse deviation from the expected experience. In attesting to the adequacy of claim liabilities, I have satisfied myself that —
(a)the company/branch* has in place proper systems and records to properly assess the claim liabilities set up in the books of accounts;
(b)the claim liabilities have been estimated using a proper and consistent method based on properly collated claims statistics. Particular attention has been paid to ‘long-tail’ business and large or catastrophic losses;
(c)the claim liabilities have been set up using a conservative approach in order to ensure that the claim liabilities maintained will be adequate to meet all ultimate claim payouts; and
(d)the reinsurance arrangements of the company/branch* have been examined and the impact arising from any of the reinsurance arrangements being rendered inadequate or ineffective has been taken into account in determining the amount of claim liabilities; except*
*   Delete whichever is inapplicable.
Name and signature of Chief Executive: _____________________________
Date: ___________________
[S 234/2013 wef 18/04/2013]