Form 701 "Data on Intermediated Business With Apra Authorised General Insurers, Lloyd's Underwriters and Unauthorised Foreign Insurers" - Australia

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Data on intermediated
business with
APRAauthorised general
insurers, Lloyd’s underwriters
and unauthorised
foreign insurers
Form 701
Australia business number
Australian financial services licensee name
Australian financial services licence number
Reporting period
Table 1: Aggregate data on intermediated business with APRA-authorised general insurers, Lloyd’s underwriters and
unauthorised foreign insurers
Premium invoiced this reporting period
Total business placed with APRA-
authorised general insurers, Lloyd’s
Effective this
Effective after the
Effective before the
Total invoiced this
underwriters and unauthorised
reporting period
reporting period
reporting period
reporting period
foreign insurers
end
start
(a)
Business placed directly by the
general insurance intermediary with
APRA-authorised general insurers
(b)
Business placed directly, or indirectly
through a foreign intermediary, by
the general insurance intermediary
with Lloyd’s underwriters
(c)
Business placed directly, or indirectly
through a foreign intermediary, by
the general insurance intermediary
with unauthorised foreign insurers
(d)
Business placed indirectly through
another general insurance
intermediary, by the general
insurance intermediary with:
(i)
APRA-authorised general
insurers; or
(ii)
Lloyd’s underwriters; or
(iii) unauthorised foreign insurers.
Total
General insurer is defined in subsection 3 (1) of the Insurance Act 1973.
Lloyd’s underwriter is defined in subsection 3 (1) of the Insurance Act 1973.
Unauthorised foreign insurer is defined in regulation 4 of the Insurance Regulations 2002.
Page 1/3
Data on intermediated
business with
APRAauthorised general
insurers, Lloyd’s underwriters
and unauthorised
foreign insurers
Form 701
Australia business number
Australian financial services licensee name
Australian financial services licence number
Reporting period
Table 1: Aggregate data on intermediated business with APRA-authorised general insurers, Lloyd’s underwriters and
unauthorised foreign insurers
Premium invoiced this reporting period
Total business placed with APRA-
authorised general insurers, Lloyd’s
Effective this
Effective after the
Effective before the
Total invoiced this
underwriters and unauthorised
reporting period
reporting period
reporting period
reporting period
foreign insurers
end
start
(a)
Business placed directly by the
general insurance intermediary with
APRA-authorised general insurers
(b)
Business placed directly, or indirectly
through a foreign intermediary, by
the general insurance intermediary
with Lloyd’s underwriters
(c)
Business placed directly, or indirectly
through a foreign intermediary, by
the general insurance intermediary
with unauthorised foreign insurers
(d)
Business placed indirectly through
another general insurance
intermediary, by the general
insurance intermediary with:
(i)
APRA-authorised general
insurers; or
(ii)
Lloyd’s underwriters; or
(iii) unauthorised foreign insurers.
Total
General insurer is defined in subsection 3 (1) of the Insurance Act 1973.
Lloyd’s underwriter is defined in subsection 3 (1) of the Insurance Act 1973.
Unauthorised foreign insurer is defined in regulation 4 of the Insurance Regulations 2002.
Page 1/3
Table 2: Transaction level data on intermediated business placed directly, or indirectly through a foreign intermediary, with
unauthorised foreign insurers
1
2
3
4
5
6
7
8
Policy
Client code
Policy code
Invoice date
Effective date
APRA class of
Premium
Currency of
transaction
business
premium
type
9
10
11
12
13
14
15
UFI name
UFI country
Exemption
HVI limb
HVI value (#)
Atypical risk
Customised
code
type
class
reason
Note: It is an offence under section 137.1 of the Criminal Code Act 1995 to provide false or misleading information to a Commonwealth entity. The
Australian Prudential Regulation Authority is a Commonwealth entity.
Lodgement requirements
Requirements for forms
lodged in writing
If information is to be lodged in Table 1 only, the licensee
may lodge the information electronically or in writing.
If a form is lodged in writing, the form must be signed in
accordance with the requirements of section 912CA of the
If information is to be lodged in both Table 1 and Table 2,
Corporations Act 2001, as modified by regulation 7.6.08C of
the licensee must lodge the information electronically. If the
the Corporations Regulations 2001.
licensee is unable to lodge the information electronically,
the licensee must arrange an alternative method of
Licensees lodging by mail or in person must lodge with
lodgement with APRA.
APRA:
(a)
the signed, original form; and
Requirements for forms
(b)
any information, statements, explanations or other
lodged electronically
matters required by the form; and
A licensee must lodge a form electronically via the licensees
(c)
any other material required by the form.
portal provided by APRA. A licensee must undertake the
Licensees lodging by email must lodge with APRA:
steps required by APRA to become authorised to use the
portal.
(a)
the signed form in PDF (portable document format);
and
A document accompanying a form may only be lodged
electronically if APRA has approved, in writing, the
(b)
any information, statements, explanations or other
electronic lodgement of documents of that kind. If APRA
matters required by the form; and
has not approved the electronic lodgement of a document,
(c)
any other material required by the form.
the document may be lodged in writing.
Licensees lodging by email must retain signed original
APRA may approve the electronic lodgement of:
copies of the forms and attachments for a period of 7 years.
(a)
a particular kind of document; or
(b)
documents in a particular class of documents.
A document is taken to be lodged with APRA electronically
if it is lodged in accordance with APRA’s approval, including
any requirements of the approval as to authentication.
Page 2/3
A form, or document, lodged with APRA in writing by, or on behalf of, an entity in an item of the following table, must be
signed by the person specified in the item.
Item
Entity
Person
1
A body that is not a foreign company
A director or secretary
2
A body that is a foreign company
(a)
a local agent; or
(b)
if the local agent is a company — a director or secretary of the company
3
An individual
An individual
4
A partnership
(a)
a partner; or
(b)
if the partner is a company — a director or secretary of the company
5
A trust
(a)
a trustee; or
(b)
if the trustee is a body — a director or secretary of the body
Note: A body includes a body corporate or an unincorporated body, for example, a society or association — see the definition of body in section
9 of the Act.
The following table must be completed. In the table, the person’s name must be printed next to the person’s signature.
Lodgement details (for the person who physically completes the form)
Firm/organisation
Contact name/position description
ASIC registered agent number (if applicable)
Telephone number
Postal address or DX address
Signature block
Name
Signature
Capacity
Entity name (if entity acting as local agent)
Date signed
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