Related provisions for DISP App 3.3.7

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PERG 5.7.1GRP
The regulated activity of assisting in the administration and performance of a contract of insurance (article 39A) relates, in broad terms, to activities carried on by intermediaries after the conclusion of a contract of insurance and for or on behalf of policyholders, in particular in the event of a claim. Loss assessors acting on behalf of policyholders in the event of a claim are, therefore, likely in many cases to be carrying on this regulated activity. By contrast, claims
PERG 5.7.3GRP
Put another way, where an intermediary's assistance in filling in a claims form is material to whether performance takes place of the contractual obligation to notify claims, it is more likely to amount to assisting in the administration and performance of a contract of insurance. Conversely, in the FCA's view, a person who merely gives pointers about how to fill in the claims form or merely supplies information in support of a claim will not be assisting in the performance of
DISP App 3.7.4ERP
Additionally, where a single premium was added to a loan:(1) for live policies:(a) subject to DISP App 3.7.5 E, where there remains an outstanding loan balance, the firm should, where possible, arrange for the loan to be restructured (without charge to the complainant but using any applicable cancellation value) with the effect of:(i) removing amounts relating to the payment protection contract (including any interest and charges); and(ii) ensuring the number and amounts of any
DISP App 3.7.5ERP
Where a claim was previously paid on the policy, the firm may deduct this from redress paid in accordance with DISP App 3.7.3 E. If the claim is higher than the amount to be paid under DISP App 3.7.3 E then the firm may also deduct the excess from the amount to be paid under DISP App 3.7.4 E.
ICOBS 2.1.1GRP
1Different provisions in this sourcebook may apply depending on the type of person with whom a firm is dealing:(1) A policyholder includes anyone who, upon the occurrence of the contingency insured against, is entitled to make a claim directly to the insurance undertaking.(2) Only a policyholder or a prospective policyholder who makes the arrangements preparatory to him concluding a contract of insurance (directly or through an agent) is a customer. In this sourcebook, customers
ICOBS 2.1.3GRP
2(1) Except where paragraph (2) applies, if a customer is acting in the capacity of both a consumer and a commercial customer in relation to a particular contract of insurance, the customer is a commercial customer.2(2) For the purposes of ICOBS 5.1.4 G and ICOBS 8.1.2 R, if, in relation to a particular contract of insurance, the customer entered into it mainly for purposes unrelated to his trade or profession, the customer is a consumer.2
PERG 5.1.1GRP
This chapter applies principally to any person who needs to know whether he carries on insurance mediation activities and is thereby subject to FCA regulation. As such it will be of relevance among others to:(1) insurance brokers;(2) insurance advisers;(3) insurance undertakings; and(4) other persons involved in the sale and administration of contracts of insurance, even where these activities are secondary to their main business.
PERG 5.1.11GRP
A person may wish to carry on activities related to other forms of investment in connection with contracts of insurance, such as advising on and arrangingregulated mortgage contracts. Such a person should also consult the guidance in PERG 2 (Authorisation and Regulated Activities), PERG 4 (Regulated activities connected with mortgages) and PERG 8 (Financial Promotion and Related Activities).
ICOBS 1.1.1RRP
1This sourcebook applies to a firm with respect to the following activities carried on in relation to a non-investment insurance contract from an establishment maintained by it, or its appointed representative, in the United Kingdom:(1) an insurance mediation activity;(2) effecting and carrying out contracts of insurance;(3) managing the underwriting capacity of a Lloyd's syndicate as a managing agent at Lloyd's;(4) communicating or approving a financial promotion;and activities
ICOBS 1.1.4GRP
Guidance on the application provisions is in ICOBS 1 Annex 1 (Part 4).
SUP App 3.10.3GRP
The meaning of contract of insurance is set out in article 3(1) of the Regulated Activities Order (Interpretation). It does not include benefit-in-kind funeral plans, which are specified in article 60 of the Regulated Activities Order (plans covered by insurance or trust arrangements). Such funeral plans (to the extent that they are insurance) are also excluded from theSolvency II Directive.7 It covers some contracts which might not otherwise be viewed as insurance in the United
SUP App 3.10.4GRP
Article 1 of the Solvency II Directive provides that the Directive “lays down rules concerning... the taking up and pursuit, within the Community, of the self-employed activities of direct insurance and reinsurance". Article7 10 of the Regulated Activities Order (Effecting and carrying out contracts of insurance) also covers reinsurance.7
ICOBS 4.2.4RRP
(1) In a sale that does not involve a personal recommendation, a firm must take reasonable steps to ensure a customer understands he is responsible for deciding whether a policy meets his demands and needs.(2) If this is done orally, the information must be provided to the customer in writing or any other durable medium no later than immediately after the conclusion of the contract. (3) If a firm anticipates providing, or provides, information on any main characteristic of a policy
ICOBS 4.2.5RRP
(1) Prior to the conclusion of an initial contract and, if necessary, on its amendment or renewal, an insurer must disclose to the customer at least:(a) the statutory status disclosure statement (see GEN 4);(b) whose policies it offers; and(c) whether it is providing a personal recommendation or information.(2) If this is done orally, the disclosure must be provided in writing or any other durable medium no later than immediately after the conclusion of the contract.
PERG 8.13.1GRP
The exemptions in Part V of the Financial Promotion Order concern financial promotions relating to deposits and contracts of insurance other than life policies. The exemptions may be combined with exemptions in Part IV and1 Part VI (see PERG 8.11.3 G (Types of exemption under the Financial Promotion Order).11
PERG 8.13.3GRP
Article 25 (Relevant insurance activity: non-real time communications: reinsurance and large risks) exempts financial promotions concerning contracts of insurance which are either contracts of reinsurance or contracts covering certain large risks.
PERG 5.14.3GRP
Professional firms should be aware of the disapplication of the exclusions for trustees (article 66) and activities carried on in the course of a profession or non-investment business (article 67) outlined in PERG 5.11.7 G (Exclusions disapplied in connection with insurance mediation) where their activities would amount to insurance mediation. Where they do not, they will still be able to rely upon article 67. Otherwise, the Nonexempt Activities Order imposes limitations on the
PERG 5.14.4GRP
As indicated in PERG 5.6.8 G, the article 72C exclusion (Provision of information on an incidental basis) is potentially available to unauthorisedprofessional firms including exempt professional firms. This may be relevant to professional firms arranging contracts of insurance for clients on an individual basis.
PERG 5.16.2GRP
Text of article 2.3 of the Insurance Mediation Directive"'Insurance mediation' means the activities of introducing, proposing or carrying out other work preparatory to the conclusion of contracts of insurance, or of concluding such contracts, or of assisting in the administration and performance of such contracts, in particular in the event of a claim.These activities when undertaken by an insurance undertaking or an employee of an insurance undertaking who is acting under the
PERG 6.2.1GRP
The purpose of this guidance is to set out:(1) at PERG 6.5 the general principles; and(2) at PERG 6.6 the range of specific factors;that the FCA regards as relevant in deciding whether any arrangement is a contract of insurance.
DISP App 3.9.3GRP
Where, for single premium policies, there were previous breaches or failings (see DISP App 3.2.7 G) the redress to the complainant should address the cumulative financial impact.
PERG 8.27.1GRP
For the purposes of article 53(1)1, advice must be given to or directed at someone who either holds investments or is a prospective investor (or their agent). Where the investment is a risk-only contract of insurance such as house contents insurance, the policyholder or prospective policyholder is regarded as an investor.
PERG 5.5.1GRP
Article 21 of the Regulated Activities Order (Dealing in investments as agent) makes dealing in contracts of insurance as agent a regulated activity. The activity is defined in terms of buying, selling, subscribing for or underwriting contracts as agent, that is, on behalf of another. Examples include:(1) where an intermediary, by accepting on the insurance undertaking's behalf to provide the insurance, commits an insurance undertaking to provide insurance for a prospective policyholder;
DISP App 3.5.1ERP
Where a complaint is about the sale of a policy, the firm should, as part of its investigation of the complaint, determine whether any claim on that policy was rejected, and if so, whether the complainant may have reasonably expected that the claim would have been paid.
ICOBS 4.3.2GRP
The fee disclosure requirement extends to all such fees that may be charged during the life of a policy.
PERG 5.10.1GRP
It must be emphasised that activities which concern invitations to renew policies and the subsequent effecting of renewal of policies are likely to fall within insurance mediation activity. Those considering the need for authorisation or variation of their permissions will wish to consider whether a process of tacit renewal operates: that is, where a policyholder need take no action if he wishes to maintain his insurance cover by having his policy 'renewed'. This process will
GEN 4.4.1RRP
(1) If, in any communication:(a) made to:222(i) 2(in relation to a non-investment insurance contract) aconsumer4;4(ii) 2(in relation to a home finance transaction) a customer; or(iii) 2(in all other cases) a retail client3; and3(b) in connection with a regulated activity carried on from an establishment of the firm (or its appointed representative) that is not in the United Kingdom;the firm indicates that it is an authorised person, it must also, where relevant, and with equal
EG 7.5.3RP
1Chapter 6 of the General Provisions module of the FCA Handbook (GEN) contains rules prohibiting a firm or member from entering into, arranging, claiming on or making a payment under a contract of insurance that is intended to have, or has, the effect of indemnifying any person against a financial penalty.