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ICOBS 6.1 General

Responsibilities of insurers and insurance intermediaries

ICOBS 6.1.1 R RP

1An insurer is responsible for producing, and an insurance intermediary for providing to a customer, the information required by this chapter and by the distance communication rules (see ICOBS 3.1). However, an insurer is responsible for providing information required on mid-term changes, and an insurance intermediary is responsible for producing price information if it agrees this with an insurer.

ICOBS 6.1.2 R RP

If there is no insurance intermediary, the insurer is responsible for producing and providing the information.

ICOBS 6.1.3 R RP

An insurer must produce information in good time to enable the insurance intermediary to comply with the rules in this chapter, or promptly on an insurance intermediary's request.

ICOBS 6.1.4 R RP

These general rules on the responsibilities of insurers and insurance intermediaries are modified by ICOBS 6 Annex 1 if one of the firms is not based in the United Kingdom, and in certain other situations.

Ensuring customers can make an informed decision

ICOBS 6.1.5 R RP

A firm must take reasonable steps to ensure a customer is given appropriate information about a policy in good time and in a comprehensible form so that the customer can make an informed decision about the arrangements proposed.

ICOBS 6.1.6 G RP

The appropriate information rule

applies pre-conclusion and post-conclusion, and so includes matters such as mid-term changes and renewals. It also applies to the price of the policy.

ICOBS 6.1.6A G RP

3The appropriate information rule applies in the same way to any policy, regardless of whether that policy is sold on its own, in connection with another policy, or in connection with other goods or services.

ICOBS 6.1.7 G RP

The level of information required will vary according to matters such as:

  1. (1)

    the knowledge, experience and ability of a typical customer for the policy;

  2. (2)

    the policy terms, including its main benefits, exclusions, limitations, conditions and its duration;

  3. (3)

    the policy's overall complexity;

  4. (4)

    whether the policy is bought in connection with other goods and services;

  5. (5)

    distance communication information requirements (for example, under the distance communication rules less information can be given during certain telephone sales than in a sale made purely by written correspondence (see ICOBS 3.1.14 R)); and

  6. (6)

    whether the same information has been provided to the customer previously and, if so, when.

ICOBS 6.1.8 G RP

In determining what is “in good time”, a firm should consider the importance of the information to the customer's decision-making process and the point at which the information may be most useful. Distance communication timing requirements are also relevant (for example, the distance communication rules enable certain information to be provided post-conclusion in telephone and certain other sales (see ICOBS 3.1.14 R and ICOBS 3.1.15 R)).

ICOBS 6.1.9 G RP

Cancellation rights do not affect what information it is appropriate to give to a customer in order to enable him to make an informed purchasing decision.

ICOBS 6.1.10 G RP

A firm dealing with a consumer may wish to provide information in a policy summary or as a key features document (see ICOBS 6 Annex 2).

Providing evidence of cover

ICOBS 6.1.11 G RP

Under Principle 7 a firm should provide evidence of cover promptly after inception of a policy. Firms will need to take into account the type of customer and the effect of other information requirements, for example those under the distance communication rules (ICOBS 3.1).

Group policies

ICOBS 6.1.12 G RP

Under Principle 7, a firm that sells a group policy should provide appropriate information to the customer to pass on to other policyholders. It should tell the customer that he should give the information to each policyholder.

Price disclosure: connected goods or services

ICOBS 6.1.13 R RP
  1. (1)

    If a policy is bought by a consumer in connection with other goods or services a firm must, before conclusion of the contract, disclose its premium separately from any other prices and whether buying the policy is compulsory.

  2. (2)

    In the case of a distance contract, disclosure of whether buying the policy is compulsory may be made in accordance with the timing requirements under the distance communication rules (see ICOBS 3.1.8 R, ICOBS 3.1.14 R and ICOBS 3.1.15 R).

  3. (3)

    2This rule does not apply to policies bought in connection with other goods or services provided as part of a packaged bank account.

ICOBS 6.1.13A G RP

5 Firms are reminded that when offering a policy as part of a packaged bank account the firm may be subject to the requirements of regulation 13 (payment accounts packaged with another product or service) of the Payment Accounts Regulations.

Exception to the timing rules: distance contracts and voice telephony communications

ICOBS 6.1.14 R RP

Where a rule in this chapter requires information to be provided in writing or another durable medium before conclusion of a contract, a firm may instead provide that information in accordance with the distance communication timing requirements (see ICOBS 3.1.14 R and ICOBS 3.1.15 R).

ICOBS 6.2 Pre-contract information: general insurance contracts

Application: what?

ICOBS 6.2.1 R RP

This section applies in relation to a general insurance contract.

Solvency II Directive disclosure requirements1

ICOBS 6.2.2 R RP

Before a general insurance contract is concluded, a firm must inform a customer who is a natural person of:

  1. (1)

    the law applicable to the contract where the parties do not have a free choice, or the fact that the parties are free to choose the law applicable and, in the latter case, the law the firm proposes to choose; and

  2. (2)

    the arrangements for handling policyholders’ complaints concerning contracts including, where appropriate, the existence of a complaints body (usually the Financial Ombudsman Service), without prejudice to the policyholders’ right to take legal proceedings.

[Note: article 183(1) to (2) of the Solvency II Directive1]

1
ICOBS 6.2.3 R RP
  1. (1)

    An EEA firm must inform a1customer, before any commitment is entered into, of the EEA State in which the head office or, where appropriate, the branch1 with which the contract is to be concluded, is situated.

    11
  2. (2)

    Any documents issued to the customer must convey the information required by this rule.

[Note: article 184(1) of the Solvency II Directive1]

1
ICOBS 6.2.4 R RP

An EEA firm must ensure that the1 contract or any other document granting cover, together with the insurance proposal where it is binding upon the customer, states1 the address of the head office, or, where appropriate, of the branch of the firm1 which grants the cover.

1 1 1

[Note: article 184(2) of the Solvency II Directive1]

1

Disclosure of cancellation right

ICOBS 6.2.5 R RP
  1. (1)

    A firm must provide a consumer with information on the right to cancel a policy.

  2. (2)

    The information to be provided on the right to cancel is:

    1. (a)

      its existence;

    2. (b)

      its duration;

    3. (c)

      the conditions for exercising it;

    4. (d)

      information on the amount which the consumer may be required to pay if he exercises it;

    5. (e)

      the consequences of not exercising it; and

    6. (f)

      the practical instructions for exercising it.

  3. (3)

    The information must be provided in good time before conclusion of the contract and in writing or another durable medium.

ICOBS 6.3 Pre- and post-contract information: pure protection contracts

Solvency II Directive disclosure requirements1

ICOBS 6.3.1 R RP
  1. (1)

    Before a pure protection contract is concluded, a firm must communicate, at least,1 the information in the table below to the customer.1

    1
  2. (2)

    The information must be provided in a clear and accurate manner, in writing, and in an official language of the State of the commitment or in another language if the policyholder so requests and the law of the State of the commitment so permits or the policyholder is free to choose the applicable law.1

    1

    3. Information to be communicated before conclusion

    (1)

    The name of the insurance undertaking and its legal form.

    (2)

    The name of the EEA State in which the head office and, where appropriate, the agency or branch1 concluding the contract is situated.

    1

    (3)

    The address of the head office and, where appropriate, of the agency or branch concluding the contract.

    1(3a)

    A concrete reference to the firm'sSFCR allowing the policyholder easy access to this information.

    (4)*

    Definition of each benefit and each option.

    (5)*

    Term of the contract.

    (6)*

    Means of terminating the contract.

    (7)*

    Means of payment of premiums and duration of payments.

    (8)*

    Information on the premiums for each benefit, both main benefits and supplementary benefits, where appropriate.

    (9)*1

    Arrangements for application of the cancellation period.

    (10)

    General information on the tax arrangements applicable to the type of policy.

    (11)

    The arrangements for handling complaints concerning contracts by policyholders, lives assured or beneficiaries1 under contracts including, where appropriate, the existence of a complaints body (usually the Financial Ombudsman Service), without prejudice to the right to take legal proceedings.

    1

    (12)

    The law applicable to the contract where the parties do not have a free choice or, where the parties are free to choose the law applicable, the law the firm1 proposes to choose.

    1

    Note: The rule on mid-term changes applies to items marked with an asterisk (see ICOBS 6.3.3 R).

[Note: article 185 of the Solvency II Directive1]

1
ICOBS 6.3.2 G RP

If the contract is concluded with a commercial customer by telephone, the information in this section may be provided immediately after conclusion.

Mid-term changes

ICOBS 6.3.3 R RP

A firm must keep a customer informed throughout the term of a pure protection contract of any change concerning1 the policy conditions, both general and special, and any change in the following information:1

1 1
  1. (1)

    the name of thefirm,1 its legal form or the address of its head office and, where appropriate, of the agency or branch1 which concluded the contract; and

    111
  2. (2)

    all the information marked ‘*’ in the table of information to be communicated before conclusion, in the event of a change in the policy conditions or amendment of the law applicable to the contract.

[Note: article 185(3) and (5) of the Solvency II Directive1]

1
ICOBS 6.3.4 R RP

1When a firm provides a customer with information in accordance with ICOBS 6.3.3 R, it must provide it in a clear and accurate manner, in writing, in an official language of the State of the commitment, or in another language if the policyholder so requests and the law of the State of the commitment so permits or the policyholder is free to choose the law applicable.

[Note: article 185(3), (5) and (6) of the Solvency II Directive]

ICOBS 6.4 Pre- and post-contract information: protection policies

Application: what?

ICOBS 6.4.1 R RP

This section applies in relation to a payment protection contract or a pure protection contract except as otherwise stated.

Oral sales: ensuring customers can make an informed decision

ICOBS 6.4.2 R RP
  1. (1)

    If a firm provides information orally during a sales dialogue with a customer on a main characteristic of a policy, it must do so for all the policy's main characteristics.

  2. (2)

    A firm must take reasonable steps to ensure that the information provided orally is sufficient to enable the customer to take an informed decision on the basis of that information, without overloading the customer or obscuring other parts of the information.

ICOBS 6.4.3 G RP
  1. (1)

    A policy's main characteristics include its significant benefits, its significant exclusions and limitations, its duration and price information.

  2. (2)

    A significant exclusion or limitation is one that would tend to affect the decision of customers generally to buy. In determining what exclusions or limitations are significant, a firm should particularly consider the exclusions or limitations that relate to the significant features and benefits of a policy and factors which may have an adverse effect on the benefit payable under it. Another type of significant limitation might be that the contract only operates through certain means of communication, e.g. telephone or internet.

Policy summary

ICOBS 6.4.4 R RP

A firm must provide a consumer with a policy summary in good time before the conclusion of a contract.

Payment protection contracts: importance of reading documentation

ICOBS 6.4.5 R RP
  1. (1)

    A firm must draw a consumer's attention to the importance of reading payment protection contract documentation before the end of the cancellation period to check that the policy is suitable for the consumer.

  2. (2)

    This must be done orally if a firm provides information orally on any main characteristic of a policy.

Price information: general

ICOBS 6.4.6 R RP

A firm must provide price information in a way calculated to enable the customer to relate it to a regular budget.

ICOBS 6.4.7 G RP

Price information is likely also to include at least the total premium (or the basis for calculating it so that the customer can verify it) and, where relevant:

  1. (1)

    for policies of over one year with reviewable premiums, the period for which the quoted premium is valid, and the timing of reviews;

  2. (2)

    other fees, administrative charges and taxes payable by the customer through the firm; and

  3. (3)

    a statement identifying separately the possibility of any taxes not payable through the firm.

ICOBS 6.4.8 G RP

Price information should be given in writing or another durable medium in good time before conclusion of the contract. This is in addition to any requirement or decision to provide the information orally. In the case of a distance contract concluded over the telephone, it may be provided in writing or another durable medium no later than immediately after conclusion.

Price information: premiums paid using a non-revolving credit agreement

ICOBS 6.4.9 R RP
  1. (1)

    This rule applies when a premium will be paid using a credit agreement other than a revolving credit agreement.

  2. (2)

    A firm must provide price information in a way calculated to enable the customer to understand the additional repayments that relate to the purchase of the policy, and the total cost of the policy.

  3. (3)

    Price information must reflect any difference between the duration of the policy and that of the credit agreement.

  4. (4)

    A firm must explain to a customer, as applicable, that the premium will be added to the amount provided under the credit agreement and that interest will be payable on it.

Price information: policies sold in connection with revolving credit arrangements

ICOBS 6.4.10 G RP
  1. (1)

    This guidance applies to policies bought as secondary products to revolving credit agreements (such as store cards or credit cards).

  2. (2)

    Price information should be given in a way calculated to enable a typical customer to understand the typical cumulative cost of taking out the policy. This does not require oral disclosure where there is a sales dialogue with a customer. However, consistent with Principle 7, a firm should ensure that this element of price information is not undermined by any information given orally.

Mid-term changes

ICOBS 6.4.11 R RP
  1. (1)

    Throughout the term of a policy, a firm must provide a customer with information about any change to:

    1. (a)

      the premium, unless the change conforms to a previously disclosed formula; and

    2. (b)

      any term of the policy, together with an explanation of any implications of the change where necessary.

  2. (2)

    This information must be provided in writing or another durable medium in good time before the change takes effect or, if the change is at the customer's request, as soon as is practicable provided the firm explains the implications of the change before it takes effect.

ICOBS 6.4.12 G RP
  1. (1)

    When explaining the implications of a change, a firm should explain any changes to the benefits and significant or unusual exclusions arising from the change.

  2. (2)

    Firms will need to consider whether mid-term changes are compatible with the original policy, in particular whether it reserves the right to vary premiums, charges or other terms. Firms also need to ensure that any terms which reserve the right to make variations are not themselves unfair under the Unfair Terms Regulations (for contracts entered into before 1 October 2015) or the CRA.1

ICOBS 6 Annex 1 Responsibilities of insurers and insurance intermediaries in certain situations

R

This annex belongs to ICOBS 6.1.4 R

The table in this annex modifies the general rules on the responsibilities of insurers and insurance intermediaries for producing and providing to a customer the information required by this chapter.

Situation

Insurance intermediary's responsibility

Insurer's responsibility

(1)

Insurance intermediary operates from UK establishment

Insurer does not operate from UK establishment

Production and providing

None

(2)

Insurance intermediary does not operate from UK establishment, is not authorised, is selling connected contracts or is authorised professional firm carrying on non-mainstream regulated activities

Insurer operates from UK establishment

Customer habitually resident in the

EEA

None

Production and providing (but no policy summary is required unless the insurance intermediary does not operate from a UK establishment)

(3)

As (2) but customerhabitually resident outside the EEA and insurer not in contact with the customer

None

None

(4)

As (2) but customerhabitually resident outside the EEA and insurer in contact with the customer

None

Production and providing

(5)

Insurance intermediary does not operate from UK establishment

Insurer does not operate from UK establishment

None

Production and providing

ICOBS 6 Annex 2 Policy summary for consumers

This annex belongs to ICOBS 6.1.10 G and ICOBS 6.4.4 R

1

Format

1.1

R

(1)

A policy summary must be in writing or another durable medium.

(2)

A policy summary must be in a separate document, or within a prominent separate section of another document clearly identifiable as containing key information that the consumer should read.

1.2

G

The quality and presentation standard of a policy summary should be consistent with that used for other policy documents.

2

Content

2.1

R

A policy summary must contain the information in the table below and no other information.

Policy summary content

• Key facts logo in a prominent position at the top of the policy summary. Further requirements regarding the use of the logo and the location of specimens are set out in GEN 5.1 and GEN 5 Annex 1 G.

• Statement that the policy summary does not contain the full terms of the policy, which can be found in the policy document.

• Name of the insurance undertaking.

• Type of insurance and cover.

• Significant features and benefits.

• Significant or unusual exclusions or limitations, and cross-references to the relevant policy document provisions.

• Duration of the policy.

• A statement, where relevant, that the consumer may need to review and update the cover periodically to ensure it remains adequate.

• Price information (optional).

• Existence and duration of the right of cancellation (other details may be included).

• Contact details for notifying a claim.

• How to complain to the insurance undertaking and that complaints may subsequently be referred to the Financial Ombudsman Service (or other applicable named complaints scheme).

• That, should the insurance undertaking be unable to meet its liabilities, the consumer may be entitled to compensation from the compensation scheme (or other applicable compensation scheme), or that there is no compensation scheme. Information on the extent and level of cover and how further information can be obtained is optional.

2.2

G

A policy summary should properly describe the policy but, in line with Principle 7, should not overload the consumer with detail.

3

Significant or unusual exclusions or limitations

3.1

G

(1)

A significant exclusion or limitation is one that would tend to affect the decision of consumers generally to buy. An unusual exclusion or limitation is one that is not normally found in comparable contracts.

(2)

In determining what exclusions or limitations are significant, a firm should, in particular, consider the exclusions or limitations that relate to the significant features and benefits of a policy and factors which may have an adverse effect on the benefit payable under it.

(3)

Another type of significant limitation might be that the contract only operates through certain means of communication, e.g. telephone or internet.

Examples of significant or unusual exclusions or limitations

• Deferred payment periods

• Exclusion of certain conditions, diseases or pre-existing medical conditions

• Moratorium periods

• Limits on the amounts of cover

• Limits on the period for which benefits will be paid

• Restrictions on eligibility to claim such as age, residence or employment status

• Excesses

4

Key features document as an alternative to a policy summary

4.1

R

A firm may provide a document that has the contents of a key features document instead of a policy summary. The document must include contact details for notifying a claim but need not include the title ‘key features of the [name of product]’.