As you are aware that an Insurance Company is a company incorporated under provisions of the Companies Act, 1956/2013, licensed under the Insurance Act, 1938 and IRDAI Act,1999. An insurance company may engage in life , general or health insurance business. The financial statements of an insurance company are prepared according to the provisions of ;
- The Companies Act,2013;
- The Insurance Laws( Amendment) Act,2015
- The IRDAI( Preparation of Financial Statements and Auditor’s Report of Insurance Companies) Regulations, 2002;
- The applicable Accounting Standards of ICAI.
It is duty of the management of the company to prepare financial statements according to the provisions of applicable laws to give true and fair views of financial results and financial position of the company at the end of the accounting period. It is legal obligation for the Board of Directors of every company to prepare and present annual accounts to the shareholders along with Annual Reports i.e. Board Report.
The Companies Act,2013 deals with the procedure and disclosures required to be furnished in Annual Reports. It also provides the procedure of approval, presentation at the meeting of Board and the members of the company of financial statements and filing the same with the Registrar of Companies each year.
ACCORDING TO SECTION 12 OF THE INSURANCE ACT, 1938, the financial statements of every insurer must be audited annually by the auditor. As prescribed by IRDA, 1999, every insurer with respect to his insurance business and also its shareholder's funds should prepare:
- A Balance Sheet;
- A Profit & Loss Account;
- Cash flow statement;
- Payments and a Revenue Account.
All these must be done as per the IRDA regulations at the end of each financial year.
SOME IMPORTANT PROVISIONS GOVERNING PREPARATION OF FINANCIAL STATEMENTS UNDER COMPANIES ACT, 2013
SECTION 92(3)-(1) Every company shall prepare a return (hereinafter referred to as the annual return) in the prescribed form containing the particulars as they stood on the close of the financial year regarding--
(a) its registered office, principal business activities, particulars of its holding, subsidiary and associate companies;
(b) its shares, debentures and other securities and shareholding pattern;
(d) its members and debenture-holders along with changes therein since the close of the previous financial year;
(e) its promoters, directors, key managerial personnel along with changes there in since the close of the previous financial year;
(f) meetings of members or a class thereof, Board and its various committees along with attendance details;
(g) remuneration of directors and key managerial personnel;
(h) penalty or punishment imposed on the company, its directors or officers and details of compounding of offences and appeals made against such penalty or punishment;
(i) matters relating to certification of compliances, disclosures as may be prescribed;
(j) details, as may be prescribed, in respect of shares held by or on behalf of the Foreign Institutional Investors; and
(k) such other matters as may be prescribed,and signed by a director and the company secretary, or where there is no company secretary, by a company secretary in practice:
Provided that in relation to One Person Company and small company, the annual return shall be signed by the company secretary, or where there is no company secretary, by the director of the company.
Provided further that the Central Government may prescribe abridged form of annual return for "One Person Company, small company and such other class of classes of companies as may be prescribed".
(2) The annual return, filed by a listed company or, by a company having such paid-up capital or turnover as may be prescribed shall be certified by a company secretary in practice in the prescribed form, stating that the annual return discloses the facts correctly and adequately and that the company has complied with all the provisions of this Act.
(3) An extract of the annual return in such form as may be prescribed shall form part of the Board's report.
(4) Every company shall file with the Registrar a copy of the annual return, within sixty days from the date on which the annual general meeting is held or where no annual general meeting is held in any year within sixty days from the date on which the annual general meeting should have been held together with the statement specifying the reasons for not holding the annual general meeting, with such fees or additional fees as may be prescribed.
(5) If any company fails to file its annual return under sub-section (4), before the expiry of the period specified therein, such company and its every officer who is in default shall be liable to a penalty of ten thousand rupees and in case of continuing failure, with a further penalty of one hundred rupees for each day after the first during which such failure continues, subject to a maximum of 8[two lakh rupees in case of a company and fifty thousand rupees in case of an officer who is an default.
(6) If a company secretary in practice certifies the annual return otherwise than in conformity with the requirements of this section or the rules made thereunder, he shall be liable to a penalty of two lakh rupees.
(1) The financial statement, including consolidated financial statement, if any, shall be approved by the Board of Directors before they are signed on behalf of the Board by the chairperson of the company where he is authorised by the Board or by two directors out of which one shall be managing director, if any, and the Chief Executive Officer, the Chief Financial Officer and the company secretary of the company, wherever they are appointed, or in the case of One Person Company, only by one director, for submission to the auditor for his report thereon.
(2) The auditors’ report shall be attached to every financial statement.
(3) There shall be attached to statements laid before a company in general meeting, a report by its Board of Directors, which shall include—
(a) the web address, if any, where annual return referred to in sub-section (3) of section 92 has been placed;
(b) number of meetings of the Board;
(c) Directors’ Responsibility Statement;
(ca) details in respect of frauds reported by auditors under sub-section (12) of section 143 other than those which are reportable to the Central Government;
(d) a statement on declaration given by independent directors under sub-section (6) of section 149;
(e) in case of a company covered under sub-section (1) of section 178, company’s policy on directors’ appointment and remuneration including criteria for determining qualifications, positive attributes, independence of a director and other matters provided under sub-section (3) of section 178;
(f) explanations or comments by the Board on every qualification, reservation or adverse remark or disclaimer made—
(i) by the auditor in his report; and
(ii) by the company secretary in practice in his secretarial audit report;
(g) particulars of loans, guarantees or investments under section 186;
(h) particulars of contracts or arrangements with related parties referred to in sub-section (1) of section 188 in the prescribed form;
(i) the state of the company’s affairs;
(j) the amounts, if any, which it proposes to carry to any reserves;
(k) the amount, if any, which it recommends should be paid by way of dividend;
(l) material changes and commitments, if any, affecting the financial position of the company which have occurred between the end of the financial year of the company to which the financial statements relate and the date of the report;
(m) the conservation of energy, technology absorption, foreign exchange earnings and outgo, in such manner as may be prescribed;
(n) a statement indicating development and implementation of a risk management policy for the company including identification therein of elements of risk, if any, which in the opinion of the Board may threaten the existence of the company;
(o) the details about the policy developed and implemented by the company on corporate social responsibility initiatives taken during the year;
(p) in case of a listed company and every other public company having such paid-up share capital as may be prescribed, a statement indicating the manner in which formal 4[annual evaluation of the performance of the Board, its Committees and of individual directors has been made];
(q) such other matters as may be prescribed.
Provided that where disclosures referred to in this sub-section have been included in the financial statements, such disclosures shall be referred to instead of being repeated in the Board’s report:
Provided further that where the policy referred to in clause (e) or clause (o) is made available on company’s website, if any, it shall be sufficient compliance of the requirements under such clauses if the salient features of the policy and any change therein are specified in brief in the Board’s report and the web-address is indicated therein at which the complete policy is available.
(3A) The Central Government may prescribe an abridged Board’s report, for the purpose of compliance with this section by One Person Company or small company]
(4) The report of the Board of Directors to be attached to the financial statement under this section shall, in case of a One Person Company, mean a report containing explanations or comments by the Board on every qualification, reservation or adverse remark or disclaimer made by the auditor in his report.
(5) The Directors’ Responsibility Statement referred to in clause (c) of sub-section (3) shall state that—
(a) in the preparation of the annual accounts, the applicable accounting standards had been followed along with proper explanation relating to material departures;
(b) the directors had selected such accounting policies and applied them consistently and made judgments and estimates that are reasonable and prudent so as to give a true and fair view of the state of affairs of the company at the end of the financial year and of the profit and loss of the company for that period;
(c) the directors had taken proper and sufficient care for the maintenance of adequate accounting records in accordance with the provisions of this Act for safeguarding the assets of the company and for preventing and detecting fraud and other irregularities;
(d) the directors had prepared the annual accounts on a going concern basis; and
(e) the directors, in the case of a listed company, had laid down internal financial controls to be followed by the company and that such internal financial controls are adequate and were operating effectively.
Explanation.—For the purposes of this clause, the term “internal financial controls” means the policies and procedures adopted by the company for ensuring the orderly and efficient conduct of its business, including adherence to company’s policies, the safeguarding of its assets, the prevention and detection of frauds and errors, the accuracy and completeness of the accounting records, and the timely preparation of reliable financial information;
(f) the directors had devised proper systems to ensure compliance with the provisions of all applicable laws and that such systems were adequate and operating effectively.
(6) The Board’s report and any annexures thereto under sub-section (3) shall be signed by its chairperson of the company if he is authorised by the Board and where he is not so authorised, shall be signed by at least two directors, one of whom shall be a managing director, or by the director where there is one director.
(7) A signed copy of every financial statement, including consolidated financial statement, if any, shall be issued, circulated or published along with a copy each of—
(a) any notes annexed to or forming part of such financial statement;
(b) the auditor’s report; and
(c) the Board’s report referred to in sub-section (3).
(8) If a company is in default in complying with the provisions of this section, the company shall be liable to a penalty of three lakh rupees and every officer of the company who is in default shall be liable to a penalty of fifty thousand rupees.
The Board’s report under sub-section (3) of section 134 shall disclose the composition of the Corporate Social Responsibility Committee, which shall be constituted according to the provisions of Section 135(1).
PLEASE NOTE THAT:- The main objective of provisions of Section 135 is formation of Corporate Social ResponsibilityCommittee of the eligible companies.
The Board’s report under sub-section (3) of section 134 shall disclose the composition of an Audit Committee and where the Board had not accepted any recommendation of the Audit Committee, the same shall be disclosed in such report along with the reasons therefor.
(1) Every listed company and a company belonging to other class of companies as may be prescribed shall annex with its Board’s report made in terms of sub-section (3) of section 134, a secretarial audit report, given by a company secretary in practice, in such form as may be prescribed.
WHAT ARE THE TYPES OF INSURANCE WHERE INSURANCE AUDITS APPLIES?
The insurance audit service applies to all types of insurance contracts, either it is for individuals or companies.
Some of the types of insurance where insurance audit is applicable are as follows:
- Property insurance that can be of stock, buildings, reserves, home.
- Liability Insurance such as employer’s liability, public liability, professional indemnity, environmental liability, product liability, etc.
- Business Interruption as well as employee embezzlement insurance.
- Insurances related to the theft of money and property.
- Transit Insurance that includes sea, air, or land.
- Life Insurances such as Permanent Insurance, Term Insurance, etc.
- Health Insurance that is individual or group insurance.
- Employees benefit Insurance Plan that includes life, accident, and health.
- Pension Insurance that includes individual or group pension insurance.
- Vehicle Insurance consisting of individual and vehicle fleet.
WHAT ARE THE ESSENTIAL POINTS CHECKED IN FINANCIAL STATEMENTS
Audit Areas in case of premium
Auditor has to apply below mentioned procedures.
A. VERIFICATION OF PREMIUM
1. In a separate bank account, the premium collections are credited. No withdrawals are generally permitted from that account for the purpose of a general expenditure.
2. As prescribed in the policy of insurance company, the collections are transferred to the Regional Office or Head office.
3. According to Section 64VB of the Insurance Act, 1938, the insurer shall assume no risk without the receipt of premium.
4. It is of utmost importance to an auditor to verify a premium because the insurance premium is collected upon issuing policies.
5. It is a consideration for bearing the risk of the insurance company.
The auditor shall verify:
1. Before starting the verification of premium income, the auditor must look into the internal controls and compliance, which is laid down for the collection and recording of premiums.
2. The cover notes must be numbered serially.
3. The auditor needs to check if the premium registers are maintained chronologically, providing complete details including GST charged according to the acceptance advice daily.
4. The auditor must verify if they figured the premium amount mentioned in the register tally with those shown in General Ledger.
5. The auditor will also verify that the installments that are due on or before the balance sheet date has been received or not, have been accounted as premium income for the year under audit.
6. Whether premium has been recognized as income over contract period of risk or not.
7. Check whether the premium is realized before the commencement of policy.
8. Check whether due to dishonored cheques the respective policies were cancelled and properly notified.
9. Check refund of premium on cancellation of insurance policies.
10. Whether reserves for Unexpired Risks have been created as the amount representing that part of the premium written which is attributable to ,and to be allocated to the succeeding accounting periods.
11. Whether unearned premium has been shown separately as Current Liability.
12. The premium received in advance shall not be included in “ Unearned Premium Account”.
13. Whether unearned premium received in advance, which represents premium income not relating to Current Accounting period , has been disclosed separately in the Financial Statements.
14. Whether necessary changes based on actuarial/ technical evaluation has been made to the liability for contracts exceeding four years.
15. Whether premium deficiency has been recognized when sum of expected claim costs, related expenses and maintenance costs exceed related unearned premium.
16. Check whether the premiums fixed for different kinds of policies were based on the advice of the actuary as well as the data base available with it and approved by the Board before filing with IRDAI.
17. Check the reasonableness of the discounts allowed by the Insurer on the premiums. He should comment on the profitability of the portfolio due to allowance of excess discounts.
18. Check, while allowing discounts, whether the claims history of group portfolio or client‘s portfolio was taken into account.
19. check the standard clauses were included in the policy documents including inclusions and exclusions.
20. If any specific additions were made, check whether additional premium were collected.
21. Check whether the subrogation clause, agreed bank clause, average clause, reinstatement clause etc., were expressly included in the policies to protect the company.
22. Check whether for coverage of additional perils, extra premium was collected appropriately.
B. VERIFICATION OF CLAIMS
1. The auditor from each division or branch must obtain the information for all classes of business.
2. The auditor shall determine the total number of documents that is to be checked, providing due importance to claims of higher value.
3. The claim account gets debited with all the payments that include the repair charges, survey fees, photograph charges etc.
4. Classification and accounting under appropriate heading in Financial Statements.
5. Completeness of liability account.
6. Accuracy of expenses.
The auditor shall verify:
1. Check the provision for unsettled claims.
a) The components of the ultimate cost of claims to an insurer comprise;
i) The claims under policies; and
ii) Specific claims settlement costs.
Please Note : Claims under policies comprise;
i) The claims made for losses incurred;
j) Those estimated or anticipated under policies following a loss occurrence.
b) The float account shows only the deposit amount. The auditor needs to verify that steps have been taken to reconcile at the year end.
6. Whether the liability for outstanding claims in respect of both Direct Business and inward Reinsurance business has rightly brought into accounts.
7. Whether all the claims have been recorded in the books of accounts and not kept outside the for any reason whatsoever.
8. Whether reserves have been made for IBNR and IBNER.
9. Whether TPA claims provisions have been made as per the statements received from TPAs.
10. Whether accounting estimates includes claims cost adjusted for estimated salvage value if there is sufficient degree of certainty of its realization.
11. Whether estimates of claims made for contracts exceeding four years has been recognized on the basis of Actuarial Report and valuation.
12. The Auditor should check details of premium received in last 15 days prior to closure of financial year and after closure of financial year.
13. The auditor should verify the claims lodged with the company within a period of 15 days before and after end of financial year.
14. Check whether proper intimation/notice was given by the insured to the insurer on the happening of fire/accident within the time prescribed.
15. Check whether the Insurer had appointed proper surveyor to assess the losses.
16. Check whether all the documentary evidences were submitted by the insured as per terms and conditions of the policy
17. Auditor should ensure that the surveyor had submitted the estimated loss within the time prescribed and the insured had given adequate cooperation in surveying the damages/perils.
18. Check whether the original policy was surrendered along with the claim application to check the title of the goods.
19. Check the documentary evidence produced by the insured about the efforts taken by him to prevent or reduce the loss due to perils and the reasonableness of the cost incurred for such prevention or minimisation of loss.
20. Check whether the average clause was enforced while settling the claims in case of under insurance.
21. Check reasonableness on the loss assessed and salvages were taken into account.
22. Check whether the claims were paid subject to exclusion clauses mentioned in the policy.
23. Auditor should ensure that the claims for losses be honoured on verifying the Total Loss, particular average, general average, salvage loss, sue and labour charges and survey charges.
24. Check whether all the larger claims were reported to the Reinsurance department in time to stake claim from the reinsurers.
C. VERIFICATION OF COMMISSION
1. The remuneration paid to an agent is made through commission. The remuneration amount is calculated by applying a percentage to the premium collected by the agent.
2. The commission is paid to the agents for the business procured, and it is then debited to commission on Direct Business Account. Insurance agents usually solicit the insurance business.
The auditor shall verify:
1. Voucher disbursement entries with regard to the disbursement vouchers with the copies of commission bills and statements.
D. MANAGEMENT EXPENSES/OPERATING EXPENSES
The auditor shall verify:
1. Expenses that are more than Rs. 5 lakhs or 1% of the net premium, whichever is higher. This must be shown separately.
E. INVESTMENT AUDIT;
1. The auditor must follow the following prescribed provisions with regard to the investments of the Insurance Act, 1938, at the time of the inspection of the investments of the insurance company:
2. An insurance company can invest only in approved securities. However, it can also invest in securities other than approved securities if the following conditions are satisfied:
a) The investments made must not exceed 25% of the total investments made.
b) The investment must be made with the consent of the board of directors.
3. An insurer must not invest in shares or debentures of an insurance or investment company over least of the following:
a) 10% of its own total calculated assets.
b) 2% of the subscribed share capital or debentures of the investee.
4. An insurance company must not invest in the shares or debentures of a company other than an insurance or investment company above at least the following:
a) 10% of its own total calculated assets.
b) 10% of the subscribed share capital or debentures of the investee.
5. An insurance company is not allowed to invest in the shares and debentures of a private company.
6. The insurance companies are not permitted to invest in funds of their policyholders outside India.
7. Check from Certificates and other details the ownership of investments ,whether they are in the name of company or not.
8. Check the method of accounting of investments ,whether it is appropriate for the company.
9. Check valuation of investment whether done on continuous period of three years or not.
10. Check whether effect of impairment has been given or not.
11. Check whether Revaluation Reserve has been made for investment in real estate sector and cash amount to be credited in case of higher valuation and in case of loss same should be debited in PL of the company.
12. Check whether in case of impairment in investment of securities a “ Fair Value Change Account” has been created or not.
13. Check whether method of accounting consistently applied by the company year to year.
14. Check whether financial statements disclose Accounting Methods applied by the company.
15. Auditor should check the action taken to dispose of the non-performing investments to salvage them.
16. Auditor should check whether there is any system with the Insurer to review the investments and categorise them into performing and non-performing.
17. Auditor should check the decisions in investment in primary markets on equities and debts.
18. Auditor should ensure that an insurer should not out of the controlled fund / assets invest or keep invested in the shares or debentures of any one company more than the exposure prescribed in Regulation 9 above, provided that nothing in this regulation shall apply to any investment made with the previous approval of the Board of the Authority by an insurer, being a company with a view toforming a subsidiary company carrying on insurance / re-insurance business.
19. Where an investment is in partly paid-up shares, the uncalled liability on such shares shall be added to the amount invested for the purpose of computing exposure norms.
20. Auditor should ensure the exposure limit for financial and insurance activities (as per Section K of NIC classification – 2008, as amended from time to time) should stand at 25per cent of investment assets for all insurers. Investment in Housing Financing Companies and Infrastructure Financing Companies (except investment in Bonds / debentures of HUDCO, NHB and only bonds issued by Housing Finance Companies having a rating of not less than AAA, and investment in Debt, Equity in dedicated infrastructure financing entities forming part of Infrastructure sector) shall form part of exposure to financial and insurance activities (as per Section K of NIC classification – 2008).
21. Auditor should check that Investment Property within the meaning of Accounting Standards, and covered under Regulation 3 (a) (6) shall not exceed, at the time of investment, 5 per cent of Investment Assets in the case of general insurer held as ‗investment property‘ should not be for ‗self-use‘. Immovable property, for self-use, should be purchased only out of share-holders funds, and should comply with circular / guidelines issued.
22. Auditor should ensure that Investment in securitized assets [Mortgaged Backed Securities (MBS) / Asset Backed Securities (ABS) / Security Receipts (SR)] both under approved and other investment category shall not exceed 5 per cent of Investment Asset in the case of General companies. Approved Investment in MBS / ABS with underlying Housing or Infrastructure Assets and not more than 5per cent of investment assets in the case of General Insurance companies. Any MBS / ABS with underlying housing or infrastructure assets, if downgraded below AAA or equivalent, shall be reclassified as Other Investments.
23. Auditor should ensure that Investment Committee should at least on a half-yearly periodicity evaluate the risk of such investments and take necessary corrective actions where the parent company (ies) is floating more than one SPV.
24. Auditor should ensure whether at the time of investing, subject to group/ promoter group exposure norms, invest a maximum of 20per cent of the project cost (as decided by a competent body) of an Public Limited Special Purpose Vehicle (SPV) engaged in infrastructure sector (or) amount under Regulation 9 (B) (i), whichever is lower, as a part of Approved Investments provided:
A) such investment is in Debt
B) the parent company guarantees the entire debt extended and the interest payment of SPV.
C) the principal or interest, if in default and if not paid within 90 days of the due date, such debt shall be classified under other investments.
D) the latest instrument of the parent company (ies) has (have) rating of not less than AA
E) such guarantee of the parent company (ies) should not exceed 20per cent of net worth of parent company (ies) including the existing guarantees, if any, given
F) the net worth of the parent company (ies), if unlisted, shall not be less than Rs. 500 crores or where the parent company (ies) is listed on stock exchanges having nationwide terminals, the net worth shall not be less than Rs. 250 Crores.
25. Auditor should check that matured investments were properly encashed and reinvested properly on the due date to avoid loss of interest.
26. Auditor should check the money market transactions and the investment and disinvestment decisions for day-to-day operations.
27. Auditor should check all the contracts on the sale/purchase of securities in the market from the dealers and ensure that only the ordered quantity of investments was purchased and sold.
28. Auditor should check the appointment of dealers of investments for day-to-day operations.
29. The Internal Auditor should check whether the decisions taken on investment or disinvestment with reasons were properly minuted.
30. Auditor should check whether the Investment Committee meet frequently to oversee the investment operations.
31. check whether the proceedings of the Investment Committee were recorded and minuted.
32. Auditor should check whether the back office, middle office front office functions and accounting functions were segregated by the insurer. Moreover, he should check that these functions should not be outsourced. If not, comment on the impact.
a) Real Estate Investments
The Auditor shall verify
1. Investment property has been measured at Historical Cost less Accumulated Depreciation and Impairment Loss( Residual value being considered as zero and not revaluation is permissible).
2. The insurer has assessed at each Balance/Sheet date any impairment in invested property.
3. Impairment losses are recognized as expenses in the Revenue/Profit and Loss Account immediately.
4. Profit on revaluation of real estate investments shall be credited in Revaluation Reserve Account of the insurer and this is a Cash Reserve.
5. Whether disclosures of Fair Market Value of investment have been made in Notes to the Accounts of the insurer.
b) Debt Securities
The Auditor should confirm that the debt securities including Government Securities and Redeemable Preference Shares have been considered " Held to Maturity" securities and valued at Historical Cost less impairment if any.
c) Equity Securities and Derivative Instruments that are traded actively in active market.
The Auditor shall verify;
1. Whether the listed equity securities and derivatives instruments that are traded in active markets have been measured at Fair Market Value as at the Balance/Sheet date.
2. Whether the insurer has assessed on each Balance/Sheet date whether any impairment of listed equity security/derivative instruments has occurred.
3. Whether unrealized loss/gain arising in changes in Fair Value of listed shares and derivative instruments have been taken to Equity Portion of Balance sheet under head “ Fair Value Change Account”.
4. Whether profit on sale of investment or loss , as the case may be includes accumulated changes in Fair Value previously recognized in Equity under the “ Fair Value Change Account” in respect of a particular security and being recycled to Profit/Loss Account on actual sale of that listed security.
5. the debit balance in the “Fair Value Change Account” has been reduced from the profits/free reserves while declaring dividends.
6. Whether company has assessed if any impairment held on each Balance/Sheet date or not.
7. The impairment loss has been recognized as an expense in Revenue/PL to the extent difference between the remeasured Fair Value of the Security/Investment and its acquisition cost as reduced by any previous impairment loss recognized as an expense in the Revenue/PL Account .
8. Whether any reversal of impairment loss ,earlier recognized in Revenue/PL Account has been recognized in Revenue /PL Account.
d) Unlisted and other than actively traded Equity Securities and Derivative Instruments.
The Auditor shall verify;
Whether unlisted securities or derivative instruments not actively traded on stock exchange has been valued at Historical Cost less impairment loss if any in the books of accounts.
We are aware that the main activities of an Insurance company is receipt of Premium, payment of claims and Investment of Funds. An insurance company may outsource its functions to third parties except its Core Activities. There are many functions of an insurance companies which are not relevant has not been considered in above checklist. The Checklist produced here can be used in both Internal as well as Statutory Audits.
DISCLAIMER: The content/information presented here is only for general information of the user and shall not be construed as legal advice. While the author has exercised reasonable efforts to ensure the veracity of information/content presented ,author shall be under no liability in any manner whatsoever for incorrect information, if any.