Annex. 1.19. Statement of Premium Information
STATEMENT OF PREMIUM INFORMATION
INS500
Name:
Period Ending:
(All amounts rounded to nearest [USD]’000)
STATEMENT OF PREMIUM INFORMATION | INS500 |
Name: |
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Period Ending: |
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(All amounts rounded to nearest [USD]’000) |
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Number of policies sold during the period | Line no. | Current quarter | Current year to date |
A | B | ||
Commercial | 1 |
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of which: |
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New policies | 2 |
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Renewals | 3 |
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Retail | 4 |
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of which: |
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New policies | 5 |
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Renewals | 6 |
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Number of policies cancelled or not renewed during the period |
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| Current quarter | Current year to date |
Commercial | 7 |
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Retail | 8 |
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Premium value of policies cancelled or not renewed during the period |
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| Current quarter | Current year to date |
Commercial | 9 |
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Retail | 10 |
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Gross Premium receivable | Line no. | Not yet due to 90 days overdue | 91-180 days | 180+ days |
A | B | C | ||
from direct customers | 11 |
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from brokers and other intermediaries | 12 |
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Premium Breakdown Amount ('000) | |||||||||||||||||||||||||||||||||||||||||||
Line of business | Line no. | Risk located in Kazakhstan | Risk located in the rest of the Eurasian Economic Union | Risk located in North America | Risk located in Europe | Risk located in the rest of the world |
| Retail Business | Commercial Business |
| Renewed policies | New Business | Unrelated business | Related Business | Direct writing | Facultative Reinsurance: Proportional | Facultative Reinsurance: Non-Proportional | Treaty Reinsurance: Proportional | Treaty Reinsurance: Non-Proportional |
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Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written |
| Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written |
| Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | Gross Premium Written | Net Premium Written | ||||||||||
| A | B | C | D | E | F | G | H | I | J |
| K | L | M | N |
| O | P | Q | R |
| S | T | U | V | W | X | Y | Z | AA | BB | CC | DD | EE | FF | ||||||||
Accident | 13 | ||||||||||||||||||||||||||||||||||||||||||
Sickness | 14 | ||||||||||||||||||||||||||||||||||||||||||
Land veAccidenthicles | 15 | ||||||||||||||||||||||||||||||||||||||||||
Railway rolling stock | 16 | ||||||||||||||||||||||||||||||||||||||||||
Aircraft | 17 | ||||||||||||||||||||||||||||||||||||||||||
Ships | 18 | ||||||||||||||||||||||||||||||||||||||||||
Goods in transit | 19 | ||||||||||||||||||||||||||||||||||||||||||
Fire and natural forces | 20 | ||||||||||||||||||||||||||||||||||||||||||
Damage to property | 21 | ||||||||||||||||||||||||||||||||||||||||||
Motor vehicle liability | 22 | ||||||||||||||||||||||||||||||||||||||||||
Aircraft liability | 23 | ||||||||||||||||||||||||||||||||||||||||||
Liability of ships | 24 | ||||||||||||||||||||||||||||||||||||||||||
General liability | 25 | ||||||||||||||||||||||||||||||||||||||||||
Credit | 26 | ||||||||||||||||||||||||||||||||||||||||||
Suretyship | 27 | ||||||||||||||||||||||||||||||||||||||||||
Miscellaneous financial loss | 28 |
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Legal expenses | 29 |
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Assistance | 30 |
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Space | 31 |
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Space liabilities | 32 |
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Life and annuity | 33 |
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Marriage and birth | 34 |
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Linked long-term | 35 |
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Permanent health | 36 |
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TOTAL: | 37 |
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Name/ Position | Signature | Date |
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Name/ Position | Signature | Date |
Instructions on Annex 1.19. template on Statement of Premium Information to the Manual is aimed at reporting on premiums.
Statement of Premium Information must be recorded and reported in compliance with the International Financial Reporting Standards and requirements of the AIFC.
Number of policies sold during the period:
Line 1. Number of commercial policies sold during the period – is the number of commercial policies sold during current period (column A) and current year to date (column B) with specifications in line 2. New policies and line 3. Renewals.
Line 4. Number of retail policies sold during the period – is the number of retail policies sold during current period (column A) and current year to date (column B) with specifications in line 5. New policies and line 6. Renewals.
Number of policies cancelled or not renewed during the period must be specified in line 7. Commercial and line 8. Retail for current period (column A) and current year to date (column B).
Premium value of policies cancelled or not renewed during the period must be specified in line 9. Commercial and line 10. Retail for current period (column A) and current year to date (column B).
Gross Premium receivables specified in line 11. From direct customers and line 12. From broker and other intermediaries for current period (column A) and current year to date (column B).
Premium Breakdown – information on Premium must be provided by information on Risk located in Kazakhstan, Risk located in the rest of the Eurasian Economic Union, Risk located in North America, Risk located in Europe, Risk located in the rest of the world, Retail Business, Commercial Business, Renewed policies, New Business, Unrelated business, Related Business, Direct writing, Facultative Reinsurance: Proportional, Facultative Reinsurance: Non-Proportional, Treaty Reinsurance: Proportional, Treaty Reinsurance: Non-Proportional segregated by Gross and Net Premium written by line of business (categories).