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ITC Claims Compliance Policies & Procedures Manual
ITC Claims Compliance Appointed
Representative Network
Policies & Procedures Manual
www.claimcompliance.co.uk
Issued by ITC Compliance Ltd: 1 Charnwood House
Marsh Road
Bristol
BS3 2NA
t: 0117 953 9068
f: 0117 953 9071
e: mail@itccompliance.co.uk
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
Contents
Introduction
ITC Compliance Network
The Concept
The Network Charter
Policies & Procedures
Treating Customers Fairly
Training and Competence
Approved Persons
Handling Complaints
Use of the FSA Logo
Client Support Activities
Data Protection
Financial Information
ITC Compliance Website & Systems
Logging on
Navigation
Submitting Monthly Returns
Record Keeping
Status Disclosure Document
Additional Information
Terms and Conditions
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
Welcome to ITC Compliance Network
Welcome to our Appointed Representative Network. We know as a new Member to the
Network, you may have many questions that you need answering. These questions could be
concerning the exact requirements of the Financial Services Authority (FSA) or be more specific
to the ITC Compliance Network and the way it works.
We would like to introduce our ITC Compliance Policies and Procedures Manual. This is your
guide to our Network which will support you and your business. Moving forward it will be used
as a reference tool and will hold a number of simple and supported systems and controls that
will ensure that you are getting the very best from our AR Network.
We are always looking at ways to develop the products and service that we offer. This will
mean from time to time you will receive updates together with instructions on how to integrate
them into your business. Please ensure that they are inserted into the relevant sections of the
manual immediately and referred to on a regular basis.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network
The Concept
As with firms selling general insurance, firms who operate a claims management function on
behalf of the customer are ‘undertaking regulated activity’ and as such must be regulated to do
so by the FSA.
The activity undertaken is caught as ‘administering the performance of an insurance contract’.
This very basically means that you are taking over some of the contractual obligations of the
insurance contract from the customer, mainly notifying and negotiating claims.
Our AR Network provides an alternative to full FSA authorisation, where a fully authorised Firm
(ITC Compliance Ltd) takes responsibility for the regulated activities of Network Members.
The sole purpose of the Network is to provide you with all of the administration tools, training
resources; professional indemnity insurance and processes you need to enable you to carry
conduct regulated activity without the burden of being directly authorised by the FSA.
As a Network member there are a few things that you will be required to do:
Provide a copy of our one page Status Disclosure Document to each customer. This may
be added to the Mandate already provided to the customer. A bespoke copy of this
document is available on the Claim Compliance Website; www.claimcompliance.co.uk
Complete a simple online multiple choice training programme, this will take no more
than 30 minutes and must be completed by all staff engaging in regulated activity
Complete a five minute monthly online return to us detailing the number of claims
administered, value of claims and simply confirm some standing data
Maintain Professional Indemnity Insurance covering Insurance activity undertaken prior
to joining ITC (advisory but not a membership requirement)
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network
The Network Charter
In allowing Network Members to operate under its authorised regulatory status, ITC
Compliance Ltd is obliged to provide them with tools, processes and procedures to enable
them to trade within regulation.
The following Charter outlines the main commitments that ITC Compliance Ltd and you, the
Network Member, agree to undertake. Full terms and conditions of business are available at
the end of the manual.
Between ITC Compliance Ltd and the Members of the Appointed Representative
Network
ITC Compliance Ltd commit to:
1. Supplying Network Members with AR status to allow them to engage in General Insurance
activity
2. Providing Professional Indemnity cover to the Network Members
3. Providing and updating as necessary the ITC Compliance Network Policies and Procedures
Manual
4. Providing an on-line Training and Competence solution for all relevant Network staff Members
5. Providing and hosting a web-based portal for mandatory monthly returns from all Network
Members
6. Giving 28 days notice of any changes that will affect Network Members
7. Undertaking a client support visit of each Network Member at least once a year
ITC Compliance Network Members commit to:
1. Treating customers fairly in line with FSA and ITC requirements
2. Following the policies and procedures outlined within this manual in good faith
3. Submitting the required monthly return in a timely and accurate manner
4. Notifying ITC Compliance Ltd of any changes to staff members that engage in regulated activity
5. Providing and maintaining a web-enabled PC in order to submit their monthly return
6. Notifying ITC Compliance Ltd of any changes in Approved Person status
7. Notify ITC Compliance Ltd when any insurance related customer complaint is received
8. Providing assistance and support at any client support visit
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Treating Customers Fairly – What it means to you
Treating Customers Fairly (TCF) is one of the FSA’s biggest priorities for businesses. The
concept is about placing responsibility on firms’ management to deliver fair outcomes for
consumers whilst offering the flexibility to deliver the outcomes in a way that suits the
business.
TCF is a continuous process – it is not something that you put in place and then forget about.
TCF needs to be included in all relevant business decisions going forward and be regularly
reviewed. TCF is wider than compliance with FSA rules. Rules cannot cover every possible
situation so it is about firms working within the spirit of the rules and asking themselves
whether compliance with specific rules is always sufficient to deliver the fair treatment of
customers.
Management Information
It is of high importance that you have appropriate processes in place to satisfy yourself that you
are treating your customers fairly. One way of achieving this is by the use of records or
Management Information. Management Information is collected during the course of day-to-
day business. It may consist of a variety of information from customers, staff, calls or visits;
this may provide an on-going record of key aspects of the business. You should be able to
clearly describe how TCF fits within your business and what behavioral action is taken to
ensure the needs, acceptance of risk, level of understanding and rights of your customers are
central to your business objectives.
Fairness
There is currently no definition of fairness. This is due to the fact that fairness means different
things to different people. Customers may also have different values, experiences and
expectations through which they interpret what they believe as being fair.
Treating Customers Fairly is not just about customer satisfaction. TCF should cover every
aspect of your business and include:
providing training for your staff that ensures quality of advice; by regularly completing
the ITC Training programme and undertaking regular observations
providing information for customers that is clear and easy to understand; through the
use of our Status Disclosure Documents
meeting customers' expectations;
putting things right if they go wrong and understanding why something went wrong to
stop it happening to other customers; and
not taking advantage of your customer by understanding our complaints procedure
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Training & Competence
Training staff and assessing their competence on the job is absolutely critical to compliance
with FSA regulation and to ensure that you treat customers fairly.
This policy statement is designed to make sure that Network Members have the processes in
place to ensure every member of regulated staff has the relevant training and assessment to
allow them to continue to engage in regulated activities.
Each member of staff that is engaging in General Insurance activity MUST complete the ITC
Compliance Ltd on-line training and competence programme, up to and including Certification
to ITC approved standard. Regulated activity includes selling, advising and recommending on
General Insurance products. Those who are assisting in the administration and performance
of a contract of Insurance are also carrying out regulated activity.
Each employee will be issued their own unique User ID and Password.
www.claimcompliance.co.uk
This must be completed BEFORE any regulated activity can be undertaken.
No other Training and Competence solution will be accepted or authorised for use by any
Network Member.
Issuing Training ID’s
In order to issue training licences to your staff you should go to www.claimcompliance.co.uk
and login with your Network Members Username and Password. Once logged in you should
select the ‘training’ tab from the top menu. From this screen you will be able to manage all of
your staff and see their training progress. Displayed on the next page is a screenshot on how
to allocate and manage your training ID’s.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual To add a new member of staff into the system simply click the ‘Click Here to Add New Staff Member’ link and you will be presented with a simple form to fill in, you will be required to enter the users’ name, job role and whether they are sales or service staff. Training Firstly, training needs must be indentified for all staff conducting General Insurance activity. When logging into the training programme you will be asked to complete a CV where you will input personal and employment information as well as selecting those areas included within your job role, this will determine the areas of assessment relevant for you. NOTE: When completing the CV section, the nominated Supervisor should tick the box confirming that they are responsible for monitoring or observing individuals. The first stage of the training course is to complete the initial assessments these will assess your understanding of insurance principles, products and regulatory aspects prior to training. Following the completion of the initial assessment, each staff member will have a bespoke action plan created according to his or her needs. Study material for each development area will then be presented in either on-line or printed format. This will then lead to a final assessment in the development areas ONLY. The member of staff can take this final assessment any number of times (Note: the number of attempts is logged by the system). © ITC Compliance Ltd 2008
ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Approved Persons
An Approved Person is the term used by the FSA to describe an individual that performs a
controlled function. A controlled function is a role or responsibility that has particular
regulatory significance. For the purposes of the Network, this means being responsible for
implementing the rules and processes outlined in this policies and procedures manual.
Every Network Member requires one Approved Person, with the exception of a Sole Trader,
where the individual IS the Business. As part of the application to join the Network, an
individual will already have been nominated to ITC Compliance Ltd and have been through the
Approved Person test to ensure their suitability for this role.
The following points must be acted upon with reference to the Approved Person regime:
1. Any changes in the Approved Person arrangements within any Network Member
must be advised to ITC Compliance Ltd IMMEDIATELY. This includes (but is not
limited to):
(a) changing your Approved Person to another individual
(b) any changes in the status of the existing Approved Person (such as incurring a
criminal conviction)
2. If the Approved Person does leave or is removed from this position, the Network
Member only has a limited time to make sure that a replacement completes the
application and passes the FSA ‘fit and proper test’.
If a replacement is not found (and installed) within this timescale, the Network
Member will lose their Network Membership status. This will result in all regulated
activity having to cease with immediate effect.
In these circumstances it is therefore essential that you inform ITC Compliance Ltd
immediately. ITC Compliance Ltd will then provide the relevant paperwork for
completion by the new Approved Person.
3. Each Network Member will, in any event, submit data monthly to refresh the
Approved Person details held by ITC Compliance Ltd. The ITC Compliance website
will prompt the user to submit the information when required.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Handling & Management of Complaints
It is possible that a customer may wish to complain or express dissatisfaction about the way
their Insurance Claims were handled or the appropriateness of insurance to their particular
needs. If this is the case, there must be a robust complaints handling mechanism in place to
ensure that complaints are dealt with in a professional and consistent manner. The complaint
process is applicable for Claims handling ONLY and NOT the standard of work carried out by
the AR.
Complaints Handling Process
In order to comply with ITC Compliance's Appointed Representative Network Terms &
Conditions all complaints received with regards to claims, whilst you are a member of our
Network, must be submitted to ITC Compliance Limited IMMEDIATELY. We will deal with the
complaint on your behalf within the agreed timescales described in the Complaint’s Handling
Procedure document whilst ensuring that you are made aware of all communications that are
sent to the complainant.
The Network Member must provide ITC Compliance Ltd with any information, assistance or
clarification as required to investigate the complaint fully and thoroughly.
The complaints must be registered whether or not the complainant appears to be justified in
his/her actions. You should register the complaint through the Claim Compliance website.
Select the ‘add a complaint’ option from the navigation page and follow the onscreen
instructions. Once you have submitted your complaint you will be presented with a Complaint
ID for your reference. From the complaints submission you will also be able to access active
and archived complaints, simply follow the onscreen instructions. Please note that only
complaints received whilst a member of our Network will need to be recorded. If you receive a
complaint with regards to claims prior to you becoming an ITC Compliance Network member, it
should be dealt with directly by you.
In the event of a serious complaint being upheld against the Network Member, ITC Compliance
Ltd reserves the right to amend or revoke Membership of the Network. Should the customer
complaint be upheld and compensation payable in line with ITC Compliance Ltd Terms &
Conditions of Business, this will be the responsibility of the Network Member and NOT ITC
Compliance Ltd.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Use of the FSA Logo and Statement
You may only use the FSA logo on letters or electronic equivalents
Business cards, compliment slips, text messages, account statements and other similar
documents are not letters (or electronic equivalents). Therefore, the licence to use the FSA
logo does not extend to documents such as these.
Copies of the logo maybe downloaded from
http://www.fsa.gov.uk/Pages/Library/Other_publications/Logos_and_Photos/copies_of_the_FSA_logo.shtml
The text to accompany the logo MUST read as follows:
[Your Name] is an Appointed Representative of ITC Compliance Limited which is Authorised
and Regulated by the Financial Services Authority
You may not use the FSA logo alone it must always be followed with the above words however
you may use the words on their own.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Client Support Activities
ITC Compliance shall conduct a client support visit of each Network Member at least once a
year. If the Network Member has more than one site, EACH site will receive a visit.
The client support visits are designed to check that Network policies and procedures are being
complied with.
The Network Member will receive a letter/email advising them of their client support visit date,
and will be expected to attend in case further assistance is needed.
If the client support visit is successful, then the Network Member can carry on with their
regulated activities.
If the client support visit is not successful, then a follow up report will be sent advising the
Network Member of the remedial action necessary. In addition, a further visit may be arranged
to ensure any remedial actions have been addressed.
NOTE: IF THE CLIENT SUPPORT VISIT IS SERIOUSLY NON-COMPLIANT. THE NETWORK
MEMBER MAY BE STOPPED FROM CONDUCTING REGULATED ACTIVITY WITH IMMEDIATE
EFFECT
FOLLOWING SUCCESSFUL REMEDIAL ACTION, PERMISSION TO CONDUCT REGULATED
ACTIVITY MAY THEN BE REINSTATED
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Data Protection Policy
Data Protection is not covered as such by the FSA regulation, but there is a legal requirement
that it be integrated into every aspect of a Network Members’ business in any case (via the Data
Protection Act 1998). This is because much of what you do with regards to Insurance products,
and even the sale of goods, involves handling, processing and storing the personal data of
customers.
Many Network Members will already have well documented policies and procedures when it
comes to dealing with customers’ data. If this is the case, this section of the manual is simply
designed to act as a refresher and reminder.
For those Members that do NOT have such a policy in place, the following points will be
invaluable. This is crucial, as the integrity of the Network can be made stronger by all parties
subscribing to good practice here.
Data Protection – the key points to remember
1. Clear desk policy – ensuring no information can be viewed or removed by others.
2. Ensure that PC’s that hold customer information (especially in a showroom
environment) are Password protected, and the Password is not disclosed to others.
3. Embrace the Data Protection Principles – these eight principles form the main thrust of
the Data Protection Act.
4. Personal data shall be processed fairly and lawfully
5. Personal data shall be obtained only for one or more specified and lawful purposes, and
shall not be further processed in any manner incompatible with that purpose or those
purposes.
6. Personal data shall be adequate, relevant and not excessive in relation to the purpose or
purposes for which they are processed.
7. Personal data shall be accurate and, where necessary, kept up to date.
8. Personal data processed for any purpose or purposes shall not be kept for longer than
is necessary for that purpose or those purposes.
9. Personal data shall be processed in accordance with the rights of data subjects under
the Act.
10. Appropriate technical and organisational measures shall be taken against unauthorised
or unlawful processing of personal data and against accidental loss or destruction of, or
damage to, personal data.
11. Personal data shall not be transferred to a country or territory outside the European
Economic Area unless that country or territory ensures an adequate level of protection
for the rights and freedoms of data subjects in relation to the processing of personal
data.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Policy Statement
Financial Information
Each Network Member will have to provide certain financial information to ITC Compliance Ltd.
Aside from ensuring that Members are satisfying certain FSA criteria regarding financially
sound businesses, it is also important to assist in maintaining the ongoing integrity of the
Network.
ITC Compliance Ltd will undertake a financial report on each application. This report will be
used to establish your suitability to join our Network and ensure that as a potential Network
Member you have provided ITC Compliance Ltd with satisfactory financial information.
WITHOLDING OR PROVIDING FALSE INFORMATION WILL RESULT IN IMMEDIATE
TERMINATION FROM THE NETWORK
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
The Claim Compliance Website
All Network Members will be expected to use the Claim Compliance website to submit their
monthly return.
No returns in any other media or format can be accepted.
In addition, there are other sections of the website that deal with training and news updates
that will be relevant to Network Members, as well as links to other sites that can provide
further information and assistance.
Logging on to the Website
Logging on is simple.
After turning on your PC and opening up your web browser, just go to the following address
www.claimcompliance.co.uk
You will be prompted to enter your Username and Password. These will have been supplied to
you by ITC Compliance Ltd, and should not be disclosed to anyone else.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
Navigating the Website
You have now logged into the site, and can start to navigate following the instructions below.
You will be presented with the Network Members Front Screen. We have designed this screen
to provide you with vital Network information. Please ensure that you read ALL sections,
complete any actions required and confirm to proceed to your monthly return.
IT IS IMPORTANT THAT YOU READ AND COMPLETE THIS SECTION ON EVERY OCCASION IT IS
PRESENTED TO YOU
1. To get in touch with ITC Compliance Ltd, click on the ‘contact’ tab. This will provide you
with the contact details required.
2. To access and print copies of document templates, such as Initial Disclosure
Documents, click on ‘FSA documents’.
3. To submit your mandatory monthly return, click on ‘monthly return’. There are more
detailed instructions on this overleaf.
4. To view previous monthly returns, click on the ‘monthly return’ tab, and scroll down to
the bottom of the page where you will be presented with all previous monthly returns for
you to select and access.
5. To access training and observation records, click on ‘training’ tab. There are more
detailed instructions on how to navigate this page further on in the manual.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual Submitting your Monthly Return The Monthly Return to ITC Compliance Ltd is of PARAMOUNT IMPORTANCE. It maintains the integrity of the Network, and has to be submitted in accordance with the agreed timescales. BE AWARE THAT LOSS OF MEMBERSHIP OF THE NETWORK WILL RESULT FROM A FAILURE TO OBSERVE THE RULES REGARDING MONTHLY RETURN SUBMISSIONS. Timescales for submission The monthly return must be submitted NO LATER THAN FIVE WORKING DAYS following a calendar month end. ALL fields must be completed – even if the information required is unchanged from the previous month. The monthly return must be submitted through the ‘monthly return’ tab on the ITC Compliance website. Under NO CIRCUMSTANCES will any other method of submission be acceptable. As a result, it is essential that you maintain your PC and ensure that it is web enabled to allow submission of the monthly return. © ITC Compliance Ltd 2008
ITC Claims Compliance Policies & Procedures Manual Procedure for submitting the monthly return 1. Log on to the Claim Compliance website – www.claimcompliance.co.uk 2. Click on the ‘monthly return’ tab. 3. You will be presented with the monthly return screen – follow the onscreen instructions. 4. Insert the information required into the fields of the monthly return. When completing your monthly return, please make sure that the following points are accurately inputted as any discrepancies will be sent back to you to rectify immediately. Step 1 For Step 1 simply select the month the returns will correspond to. Select the month. Step 2 You are required to answer the two following questions based on claims within the selected month 1. How many Claims have been administered? 2. Enter the total value of ALL Claims administered? All fields must be completed with a figure, £ signs should be used when entering you monthly figures. Step 3 In this step you will need to enter four pieces of information: Have any regulated members of staff left the organisation? If you click yes you should select those leavers from the list; hold down the ‘ctrl’ key to select multiple leavers. Do you have any new members of staff dealing with regulated products? For this you should enter the new starters name as well as their job role, they will then be issued with Training ID’s on the following screen and training should be carried out no more than two weeks after starting with the organisation. (Training ID’s are always accessible after completing your return from the ‘training’ tab.) Have there been any changes to the company’s Approved Person? If the answer to this is ‘yes’ then you must complete the notification form in full. © ITC Compliance Ltd 2008
ITC Claims Compliance Policies & Procedures Manual Have you had any complaints regarding Claims this month? If you click ‘yes’ then you will be required to input details of each complaint received. After proceeding with this step you will be shown a copy of the completed return this should be signed, printed and be submitted along with your paper returns to ITC Compliance Ltd. Should you require any further assistance you can call ITC Compliance Ltd on 0117 953 9068 Option 2. © ITC Compliance Ltd 2008
ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Network Systems
Record Keeping
FSA regulation demands rigorous record keeping in certain areas. This is to ensure that where
regulated activity has taken place, it has been conducted in accordance to FSA rules.
In addition, record keeping is required to show staff training and competence levels and
ongoing monitoring of the same.
The FSA can demand that the written records of the activities regarding Network Members be
made available within 48 hours. This makes the need for a rigorous record keeping regime
even more important!
The following procedures highlight what records should be kept, and for how long:
Training and Competence Records
Training and Competence records include the CV and assessments sections from the ITC
Compliance on-line learning system. Observation reports that assess staff as competent will
also be included in this area.
These records will need to be kept for a period of at least three years following the person
ceasing to conduct General Insurance Activities.
All Training and Competence records are kept within the ITC Compliance on-line learning
system. A Network Member can access his or her own information through this system at any
time.
.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
Example Status Disclosure Document
ITC Compliance Ltd
a: Unit 1 Charnwood House, Marsh Road, Bristol, BS3 2NA
tel: 0117 953 9068 fax: 0117 953 9071
STATUS DISCLOSURE INFORMATION
The Financial Services Authority (FSA) is the independent regulator of financial services. Use this information to
decide if our services are right for you.
(Organisation) is an appointed representative of ITC Compliance Limited which is authorised and regulated by the
FSA (their registration number is 313486) and which is permitted to advise on and arrange general insurance
contracts.
You will not be charged any additional fees for services related to us managing your insurance claim.
IMPORTANT:
You WILL NOT receive advice or a recommendation from us regarding your insurance claim. We will ask some
questions to enable us to accurately report your claim to your insurer. It is important that you provide all relevant
information (material facts) about your claim. Failure to do so could result in your claim being declined by your
insurer.
We always aim to provide a first class service, however if you have any cause for complaint any enquiry in the first
instance should be addressed in writing to The Compliance Officer, ITC Compliance Limited, at Charnwood House,
Marsh Road, Bristol, BS3 2NA. Should you remain dissatisfied you have the right to ask the Financial Ombudsman
Service to review your case. You should write to the Financial Ombudsman Service, South Quay Plaza, 183 Marsh
Wall, London E14 9SR. Telephone 0845 080 1800. You may be entitled to compensation should we be unable to
meet our liabilities as an insurance intermediary under the Financial Services Compensation Scheme. Your
entitlement to compensation will depend upon the type of business and the circumstances of your claim.
Details of ITC Compliance Limited’s authorisation (including their authorised number 313486) can be confirmed by
contacting the FSA on 0845 606 1234 or by visiting the FSA’s website http://www.fsa.gov.uk/register.
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
ITC Compliance Terms & Conditions
PARTIES
1. ITC Compliance Limited (t/a “ITC Compliance”) whose registered office is at 1 Charnwood
House, Marsh Road, Bristol, BS3 2NA (“ITC COMPLIANCE LTD”); and
2. You or your limited company, (the “AR”).
RECITALS
ITC COMPLIANCE LTD is authorised by the FSA and as such is regulated by the FSA in the
conduct of general insurance administration. ITC Compliance Limited wishes to appoint the AR as
its non-exclusive representative to provide certain general insurance administration services and
the AR, who is not authorised by the FSA, has agreed to do so on the terms and subject to the
conditions of this Agreement.
AGREED TERMS
1. INTERPRETATION
In this Agreement:-
Definitions:
Including the recitals the following words and expressions shall have the following meanings:
“Appointed Representative” a person or legal entity so appointed by an Authorised Firm in
accordance with the FSMA who is thereby exempt from the
general prohibition against carrying out general insurance
administration under the FSMA;
Approved Person” a person in relation to whom the FSA has given its approval
under the FSMA for the performance of the Controlled
Functions;
“Authorised Firm” a firm with permission from the FSA to carry out general
insurance administration activities as referred to in the FSMA;
“Business Day” any day which is not a Saturday, a Sunday or a Public Holiday
“Commencement Date” The agreement date (above);
“Complaint” any oral or written expression of dissatisfaction about any
insurance activity provided or withheld by the AR or ITC
COMPLIANCE LTD whether justified or not;
“Compliance Manual” that issued by ITC COMPLIANCE LTD to the AR from time to
time;
“Confidential Information” information of a confidential nature (including trade secrets
and information of commercial value) known to and
concerning ITC COMPLIANCE LTD and the Products and
communicated to the AR by ITC COMPLIANCE LTD;
“Customer” a customer for the Products, and includes, where appropriate,
a potential customer;
“Controlled Functions” those prescribed by the Regulations;
“FSA” the Financial Services Authority;
“FSMA” the Financial Services and Markets Act 2000 ;
“Intellectual Property” any patent, copyright, registered design, unregistered design
right, trademark or other industrial or intellectual property
owned or used by ITC COMPLIANCE LTD together with any
current applications for any registerable items of the
foregoing;
“Products” any insurance products provided by a Product Provider
“Product Provider” an insurer authorised by the FSA to provide a Product;
“Regulated Activities” those activities set out in Part IV of FSMA; and
“Regulations” laws and regulations applicable to the Products, including, but
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
not limited to the FSMA and the rules and regulations made
thereunder by the FSA from time to time, including, but not
limited to the FSA’s Handbook, and any amendments thereto
or replacements thereof.
1.2 Subordinate Legislation Any references to a statutory provision shall include any
subordinate legislation made from time to time under that provision.
1.3 Modifications etc of Statutes. Any reference to a statutory provision or regulation or to the
FSA rules shall include that provision, regulation or rule as from time to time modified or
re-enacted.
1.4 General
References to Clauses and Schedules are to clauses and schedules of this Agreement. The
Schedules to this Agreement shall form part of this Agreement. Headings are for
convenience only and shall be ignored in interpreting this Agreement.
2. APPOINTMENT
2.1 ITC COMPLIANCE LTD hereby appoints the AR as its non-exclusive Authorised
Representative to undertake claims administration on the terms of this Agreement and the
AR hereby accepts the appointment on those terms.
2.2 During the term of this Agreement the AR shall at all times:
(i) generally carry out its responsibilities under this Agreement in such
manner to best promote the interest of ITC COMPLIANCE LTD;
(ii) describe itself in all dealings with or relating to the Products (including,
for the avoidance of doubt, the issuance of promotional materials) and at
its premises as the Appointed Representative of ITC COMPLIANCE LTD;
(iii) not become an Authorised Firm;
(iv) not be appointed as the Appointed Representative of another
Authorised Firm other than ITC COMPLIANCE LTD or any other Company
nominated by ITC COMPLIANCE LTD from time to time.
(v) not act in a way which will incur any liabilities on behalf of ITC
COMPLIANCE LTD nor shall the AR pledge the credit of ITC COMPLIANCE
LTD.
2.3 ITC COMPLIANCE LTD may at any time by notice prohibit, suspend or restrict the AR from
some or all of such things as may be specified in the notice.
2.4 The AR is not permitted to undertake the administration of claims until it is included on
the FSA register as appointed for that purpose and has been advised in writing by ITC
Compliance Limited that it has permission to do so.
3. ITC COMPLIANCE LTD’s UNDERTAKINGS
3.1 During the term of this Agreement ITC COMPLIANCE LTD undertakes and agrees with the
AR that it shall:
(i) from the Commencement Date, be authorised to carry on the Regulated
Activities permitted by the FSA. (A copy of ITC COMPLIANCE LTD’s
authorisation by the FSA shall be made available if requested by the AR);
(ii) act within the scope and limitations of its authorisation;
(iii) issue the Compliance Manual to the AR to assist the AR to comply with
its obligations under this Agreement;
4. APPOINTED REPRESENTATIVE’S WARRANTIES
4.1 During the term of this Agreement, the AR warrants to ITC COMPLIANCE LTD that it shall:
(a) be solvent as assessed, amongst other things, in accordance with the
Regulations;
(b) be suitable to act for ITC COMPLIANCE LTD in the capacity of Appointed
Representative in accordance with the Regulations;
(c) have no “close links” (as defined in the FSA Handbook) which would be
likely to prevent the effective supervision of the AR by ITC COMPLIANCE
LTD;
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(d) be able to deliver the same level of protection to Customers as if they had
dealt with ITC COMPLIANCE LTD itself;
(e) Maintain up to date the training and observations of all staff undertaking
regulated activity (at least annually).
(f) Not undertake any insurance sales
(g) maintain adequate controls over the Regulated Activities it carries on
under this Agreement for which ITC COMPLIANCE LTD has responsibility
under FSMA;
(h) have adequate resources to monitor compliance with this Agreement;
(i) have an Approved Person who meets the FSA’s criteria for approval, and
who shall carry out their Controlled Functions in accordance with the
FSA’s standards published from time to time;
(j) have controllers, directors, proprietors and managers of the AR that are of
good character, are competent, and are of sufficient financial standing to
enable them to undertake their responsibilities under this Agreement;
(k) not have, prior to the commencement of this Agreement, made an
unsuccessful application to the FSA to become an Authorised Firm;
(l) disclose any application to the FSA to become an Authorised Firm and any
documents relating to an unsuccessful application that is made by the
AR.
5. RESPONSIBILITIES OF THE APPOINTED REPRESENTATIVE
5.1 The AR shall act towards ITC COMPLIANCE LTD conscientiously and in good faith and in
such way as to enable ITC COMPLIANCE LTD to comply properly with any limitations or
requirements on its own permission to carry out Regulated Activities, and shall not allow
its own interests to conflict with the duties that it owes to ITC COMPLIANCE LTD under
this Agreement and the general law.
5.2 The AR shall maintain at its own expense appropriate offices, display, administration
facilities and systems as may be necessary for the effective performance of its duties
under this Agreement, and shall take reasonable care to organise and control its affairs
responsibly and effectively, with adequate risk management systems; including the
maintenance or procurement of Professional Indemnity Insurance to cover any regulated
activity which may have occurred prior to commencing regulated activity as an Appointed
Representative of ITC Compliance Limited.
5.3 The AR hereby undertakes and agrees that it shall not accept (and it shall procure that
none of its staff or other representatives accept) any secret profit, income or other benefit
or inducement (in what ever form the same may be offered or provided) from any Product
Provider (or any other person, firm or company) which does or may provide an incentive or
reason for the AR (or any member of its staff or other representative) to vary its attitude
towards its regulated activity in preference of one course of action over another (including,
by way of example only, any gifts or vouchers or other like incentive).
5.4 In the event that ITC COMPLIANCE LTD suffers or becomes liable to pay any levy or
contribution to or at the direction of the FSA on behalf of or in relation to the AR (or any
activity undertaken by the AR), then the AR will forthwith upon demand from ITC
COMPLIANCE LTD, pay such levy or contribution (or such part thereof as relates to or is
attributable to the AR or its business) to ITC.
5.5 Notwithstanding any other provision of this Agreement, the AR hereby undertakes and
agrees to indemnify ITC COMPLIANCE LTD (including all of its officers, employees and
other representatives) and keep it (and them) indemnified at all times against all claims,
costs, losses, liabilities, fines, expenses, demands and/or proceedings which ITC
COMPLIANCE LTD (and/or any of its officers, employees or other representatives ) may
suffer or incur or which may be made or brought against it (or any such person) arising
out of or as a result of any breach by the AR of its obligations under this Agreement
including (without prejudice to the generality of the forgoing) any fines, fees or other form
© ITC Compliance Ltd 2008ITC Claims Compliance Policies & Procedures Manual
of award or compensation which may be made or levied against ITC COMPLIANCE LTD (by
whatever Court or regulatory authority) as a result of any complaint or allegation made by
a Customer of the AR or as a result of any breach (or alleged breach) by the AR (or anyone
for whom the AR is responsible) of any rules or regulations made by or with the authority
of the FSA (including the Regulations). This indemnity shall also extend to any costs or
expenses incurred by ITC COMPLIANCE LTD in investigating and defending and any
payment (whether of compensation or a fine or otherwise) made or required to be made by
ITC COMPLIANCE LTD as a result of any claim, complaint, arbitration, regulatory
investigation or disciplinary or enforcement action taken, levied or incurred as a result of
or arising out of any activity or omission on the part of the AR.
6. APPROVED PERSONS OF THE APPOINTED REPRESENTATIVE
6.1 During the term of this Agreement the AR shall ensure that one of its directors is
approved under Section 59 of the FSMA for the performance of certain Controlled
Functions in relation to a Regulated Activity.
6.2 The AR shall inform ITC COMPLIANCE LTD in writing of a proposed change of the
Approved Person no less than 90 days before the change of Approved Person is due to
come into effect.
6.3 The Approved Person shall act at all times in accordance with the Regulations and the
FSA’s Statements of Principle for Approved Persons as amended or replaced from time to
time.
6.4 The AR shall advise ITC COMPLIANCE LTD in writing immediately of any factors that may
affect the continued suitability of its Approved Person to perform the function of an
Approved Person.
7. TRAINING, COMPETENCE AND RECRUITMENT
7.1 The AR shall comply at all times with the FSA’s rules on training and competence
including the rules on recruitment and shall ensure that any employees of the AR in
respect of whom the relevant rules apply, (including the Approved Person of the AR), are
appropriately trained and observed in accordance with the reasonable requirements of ITC
COMPLIANCE LTD, and undertake annual retraining as required by ITC COMPLIANCE
LTD.
7.2 If the AR intends to recruit an individual employee with a view to that individual engaging
in the administration of Products as well as compliance to the Regulations, the AR shall,
as part of its recruitment procedures:
(i) take into account the knowledge and skills of the individual in relation
to the knowledge and skills required for the role; and
(ii) take reasonable steps to obtain sufficient information about the
individual’s previous relevant activities and training, including any
approved examination passes, from a suitable source within a
reasonable time. To the extent that the individual recruited has not
undertaken training specific to the Products, the AR shall ensure that
the individual undergoes such training before engaging in the claims
administration of the Products.
7.3 If the AR engages an employee engaging in the administration of Products, the AR shall
maintain with each such employee at all times an effective contract of employment or for
services which incorporate an Agreement to observe and perform this Agreement. The AR
shall provide to ITC COMPLIANCE LTD upon reasonable request a copy of its standard
contract of employment or for services of such employees and provide details of all
variations thereto within three business days of such variation.
7.4 ITC COMPLIANCE LTD will provide training to the AR in the form of its on-line Training
and Competence programme.
8. INFORMATION, REPORTING AND NOTIFICATION REQUIREMENTS
8.1 ITC COMPLIANCE LTD is responsible for notifying the FSA of any change to the initial
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notification of the appointment of an Appointed Representative not more than 10 business
days after the date the appointment takes effect. The notification includes the following
details:
(i) the registered name of the Appointed Representative;
(ii) a trading name under which the Appointed Representative
carries on a regulated activity in that capacity.
8.2 The AR shall supply ITC COMPLIANCE LTD with such information within 3 business days
as it may reasonably require from time to time to enable ITC COMPLIANCE LTD to monitor
continuing compliance with the warranties contained in Clause 4 of this Agreement and
the terms of this Agreement.
8.3 The AR shall co-operate with the FSA when gathering information on its own initiative
which require the co-operation of the AR and shall when requested give immediate access
to its premises, documents, and personnel and the AR shall take reasonable steps to
ensure that its employees, agents and any other members of its group and their
employees and agents also co-operate with the FSA.
8.4 The AR shall give to the duly authorised employees and agents of ITC COMPLIANCE LTD,
including its auditors, a right of access at all times to the AR’s accounting and other
records, in whatever form they are held, and documents relating to its obligations under
this Agreement. The AR shall allow ITC COMPLIANCE LTD’s auditors to copy documents
or other material on its premises and to remove copies or hold them elsewhere, or give to
the auditors such copies on request. The AR’s officers shall provide to ITC COMPLIANCE
LTD’s auditors such information and explanations as they reasonably consider necessary
for the performance of their duties as auditors.
8.5 If any compliance deficiencies are identified as a result of the audits performed pursuant
to this clause, such deficiencies shall be addressed and rectified by the AR within such
period as shall be reasonably stipulated by or on behalf of ITC COMPLIANCE LTD and the
costs thereof shall be borne by the AR. If any such compliance deficiencies are not
rectified within agreed timescales to the satisfaction of ITC COMPLIANCE LTD, the
agreement herein shall be terminated with immediate effect. Such notification will be
provided in writing by ITC COMPLIANCE LTD
9. COMPLAINTS HANDLING
9.1 All complaints related to business governed by this Agreement (written or otherwise)
received by the AR shall be reported immediately to ITC COMPLIANCE LTD and copies of
any written complaint shall be forwarded to ITC COMPLIANCE LTD within three business
days.
9.2 Complaints shall be handled, recorded and reported by the AR and ITC COMPLIANCE LTD
strictly in accordance with the Compliance Manual.
9.3 The AR shall provide such access, information, records and documents as ITC
COMPLIANCE LTD or the FSA may request in investigating any matter or complaint
related to business governed by this Agreement made to about or in any way involving the
AR whether before or after the termination of this Agreement and shall procure that its
employees are available at all reasonable times to answer questions in relation to such
matters.
10. FEES AND CHARGES
The fees and charges payable by the AR to ITC COMPLIANCE LTD in relation to the
appointment of the AR as ITC COMPLIANCE LTD’s representative pursuant to the terms of
this Agreement, including the basis of their calculation and how frequently they are to be
paid, are set out in the Schedule to this Agreement.
11. INDEMNITY
11.1 The AR covenants with ITC COMPLIANCE LTD to indemnify ITC COMPLIANCE LTD against all
claims, proceedings, liabilities, costs, charges and expenses which ITC COMPLIANCE LTD
may incur:
(i) in consequence of anything done or purported to be done by the AR under this
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Agreement;
(ii) any failure by the AR to comply with the AR’s obligations hereunder; and
(iii) in consequence of anything done or purported to be done outside the terms of
this Agreement and outside its respective authority.
12. ADVERTISING AND PROMOTIONS
12.1 ITC COMPLIANCE LTD shall provide the AR with information on advertising and promotion
carried out by ITC COMPLIANCE LTD in support of the Products.
12.2 The AR shall be responsible for the advertising and promotion of the Products in its
organisation, and on its website and in other publications in which it advertises and the costs
associated therewith.
12.3 The AR shall withdraw any advertising and promotional materials when requested to do so
by ITC COMPLIANCE LTD.
13. COMPLIANCE WITH LAWS AND REGULATIONS
13.1 ITC COMPLIANCE LTD and the AR shall comply at all times with:
(i) the Regulations and with the general law;
(ii) the FSA Principles for Approved Persons and the FSA Code of Practice for
Approved Persons;
(iii) best market practice in relation to its business; and
(iv) the Compliance Manual.
13.2 ITC COMPLIANCE LTD shall give the AR as much advance notice as possible of any
prospective or actual changes in the Regulations or any prospective or actual change in any
condition or limitation on its authorisation by the FSA by the date of implementation of that
change or as soon as is reasonably practicable thereafter.
13.3 The Compliance Manual shall be governed by the terms of this Agreement and in the event
of inconsistency with this Agreement, the terms of the this Agreement shall prevail.
14. INTELLECTUAL PROPERTY
14.1 The AR acknowledges that the Intellectual Property (including the goodwill connected with
ITC COMPLIANCE LTD’s name and business) belong solely to and shall at all times remain
vested solely in ITC COMPLIANCE LTD.
14.2 The AR accepts that:
(i) it is only permitted to use the Intellectual Property for the purposes of and
during the term of this Agreement and only as authorised by ITC
COMPLIANCE LTD hereunder;
(ii) other than to the extent detailed in (i) above, it has and shall have no right to
use or allow others to use the Intellectual Property or any part of it. It shall
not seek to register any Intellectual Property on behalf of ITC COMPLIANCE
LTD without ITC COMPLIANCE LTD’s express consent;
(iii) it shall not use any trademark or trade names or similar devices which
resemble the ITC COMPLIANCE LTD’s trademarks or trade names or similar
devices and which would therefore be likely to confuse or mislead the public
or any section of the public;
(iv) it shall not remove, alter or otherwise tamper with any trademarks, trade
names, logos or other of identification on the Products which come into its
possession or control, and shall not place any trademark or trade name of its
own upon the Products or any other materials used in connection therewith;
(v) it shall not do or omit to do or authorise any third party to do or omit to do
anything which would invalidate or be inconsistent with the Intellectual
Property;
(vi) it shall make a statement in any advertising material and promotional
literature produced by or for it in connection with the Products as to the
ownership as to any relevant Intellectual Property used or referred to
therein.
15. DURATION AND TERMINATION
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15.1 This Agreement shall come into effect on the the date you appear on the official FSA register
of regulated firms and shall continue in force until terminated as hereinafter provided..
15.2 ITC COMPLIANCE LTD and the AR may terminate this Agreement by giving not less than 6
calendar month’s notice in writing provided that the FSA and ITC COMPLIANCE LTD or either
of them does not require this Agreement to continue for the purposes of investigating
potential breaches of Clause 14 hereof.
15.3 ITC COMPLIANCE LTD may give notice in writing to the AR terminating this Agreement with
immediate effect if:
(a) at any time ITC COMPLIANCE LTD has reasonable grounds to believe that the
conditions in Clause 4.1 are not satisfied or are likely not to be satisfied, and
the AR is unable to take immediate steps to rectify the matter;
(b) the AR commits any serious breach of any of the terms of this Agreement
and that breach (if capable of remedy) is not remedied within 5 business days
of notice being given by ITC COMPLIANCE LTD requiring it to be remedied;
(c) the AR carries on or threatens to carry on any Regulated Activities in breach
of the general prohibition in section 19 of the FSMA;
(d) the AR becomes an Authorised Firm;
(e) The AR becomes an Appointed Representative of another AR network;
(f) ITC COMPLIANCE LTD receives notification that its permission from the FSA
to carry out Regulated Activities has been or is to be withdrawn;
(f) ITC COMPLIANCE LTD is no longer able to comply properly with any
limitations or requirements on its own permission or loses its permission to
carry out Regulated Activities by the FSA;
(g) the AR is in breach of any other agreement with ITC COMPLIANCE LTD;
(h) an order is made or a resolution is passed for the winding-up of the AR or an
order is made for the appointment of an administrator to manage the affairs,
business and property of the AR, or such an administrator is appointed or
documents are filed with the court for the appointment of an administrator or
notice of intention to appoint an administrator is given by the AR or its
directors or by a qualifying floating charge holder (as defined in paragraph 14
of Schedule B1 to the Insolvency Act 1986), or a receiver and/or manager or
administrative receiver is appointed in respect of all or any of the AR’s assets
or undertaking or circumstances arise which entitle the Court or a creditor to
appoint a receiver and/or manager or administrative receiver or which entitle
the Court to make a winding-up or bankruptcy order or the AR takes or
suffers any similar or analogous action in consequence of debt;
(i) the AR ceases, or threatens to cease, to carry on business;
(j) the AR assigns or purports to assign its rights or obligations under this
Agreement.
15.4 For the avoidance of doubt, a breach of any of Clauses 4.1, 5, 6, 7 , 8.4, 8.5, 9.3, 10 and 13.3 is a
serious breach for the purposes of Clause 16.3 (b).
16. EFFECTS OF TERMINATION
16.1 Termination of this Agreement however caused shall be without prejudice to any rights or
liabilities accrued at the date of termination.
16.2 Upon termination of this Agreement for any reason:
(a) the AR shall cease to manage claims;
(b) the AR shall immediately cease to describe itself as an “Appointed
Representative” of ITC COMPLIANCE LTD and cease to use all trade marks
or trade or brand names of ITC COMPLIANCE LTD;
(c) the AR shall at its own expense within 30 days return to ITC COMPLIANCE
LTD all advertising and promotional material relating to the Products then in
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the possession of the AR or otherwise dispose of the same as ITC
COMPLIANCE LTD may instruct.
16.3 For the avoidance of doubt, the provisions of Clause 5 shall, notwithstanding termination,
continue in force in relation to all claims management where the administration of the claim
has been concluded before the date of termination.
16.4 Termination shall not affect the operation of those clauses of this Agreement which are, by
their nature, intended to survive and continue in force notwithstanding the termination of
this Agreement.
16.5 Subject as herein provided and to any rights or obligations accrued prior to termination,
neither party shall have any further obligation to the other under this Agreement.
16.6 In the event of termination of this agreement by either ITC COMPLIANCE LTD or the AR, no
refund of any fees paid shall apply.
17. CONFIDENTIALITY
17.1 The AR agrees that it shall at all times (both during the term of this Agreement and after its
termination) keep confidential, and shall not use (other than strictly for the purposes of this
Agreement) and shall not without the prior written consent of ITC COMPLIANCE LTD disclose
to any third party any Confidential Information, unless the information:
(a) was public knowledge or already known to the AR at the time of disclosure; or
(b) subsequently becomes public knowledge other than by breach of this Agreement;
or
(c) subsequently comes lawfully into the possession of the AR from a third party.
17.2 To the extent necessary to implement the provisions of this Agreement (but not further or
otherwise), the AR may disclose the Confidential Information to any Customers or
prospective Customers, to any relevant governmental or other authority or regulatory body
including the FSA, and, and to any employees of the AR or of any of the above provided that
before any such disclosure the AR shall make those persons aware of its obligations of
confidentiality under this Agreement and shall obtain a binding undertaking as to
confidentiality from all such persons.
17.3 All documents and other records (in whatever form) containing Confidential Information
supplied to or acquired by the AR from ITC COMPLIANCE LTD shall be returned promptly to
ITC COMPLIANCE LTD on termination, and no copies shall be kept.
18. DATA PROTECTION
18.1 The AR’s attention is hereby drawn to the Data Protection Act 1998 and to Directive 95/46/EC
of the European Parliament and any regulations implementing it (all referred to together as
the “Data Protection Requirements”).
18.2 The AR warrants that it shall duly observe all its obligations under Data Protection
Requirements which arise in connection with this Agreement by the AR. In particular, the AR
warrants that it holds up to date and adequate data protection notifications. The AR shall, if
requested by ITC COMPLIANCE LTD, supply to ITC COMPLIANCE LTD copies of all such
notifications and any other documentation relating to compliance with the Data Protection
Requirements.
18.3 In particular, and without limitation, as required by Schedule 1, Part II of the Data Protection
Act 1998, the AR shall:
19.3.1 only act on instructions from ITC COMPLIANCE LTD as data controller and
only carry out processing (as defined by the Data Protection Act 1998);
19.3.2 take appropriate technical and organisational measures against
unauthorised or unlawful processing of Personal Data (as defined in the
Data Protection Act 1998) and against accidental loss or destruction of or
damage to any Personal Data;
19.3.3 not transfer any Personal Data to any third parties, or outside the countries
of the European Economic Area, without and only to the extent of any
express written consent of ITC COMPLIANCE LTD, which may be refused at
ITC COMPLIANCE LTD’s sole discretion;
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