Automatic Self Administered YRT Reinsurance Agreement between American National Insurance Company One Moody Plaza, Galveston, TX 77550 (hereinafter referred to as the "Ceding Company") and Swiss Re Life & Health America Inc. Hartford, CT (hereinafter...
between
American
National Insurance Company
Xxx Xxxxx
Xxxxx, Xxxxxxxxx, XX 00000
(hereinafter
referred to as the "Ceding Company")
and
Swiss Re
Life & Health America Inc.
Hartford,
CT
(hereinafter
referred to as the "Reinsurer")
Effective:
April 14, 2008
Treaty #:
Executive UL
SRLHA
#I96319US- 08
Table
of Contents
PREAMBLE 4
1.1 PARTIES
TO THE
AGREEMENT 4
1.2 COMPLIANCE 4
1.3 CONSTRUCTION 4
1.4 ENTIRE
AGREEMENT 4
1.5 SEVERABILITY 4
AUTOMATIC
REINSURANCE 4
2.1 GENERAL
CONDITIONS 4
2.2 RETAINED
AMOUNTS 5
FACULTATIVE
REINSURANCE 5
LIABILITY 5
COMMENCEMENT
OF LIABILITY 6
4.1 AUTOMATIC
REINSURANCE 6
4.2 FACULTATIVE
REINSURANCE 6
4.3 CONDITIONAL
RECEIPT OR TEMPORARY INSURANCE 6
REINSURED
RISK AMOUNT 6
5.1 LIFE 6
5.2 WAIVER
OF PREMIUM 6
5.3 ACCIDENTAL
DEATH BENEFIT 6
PREMIUM
ACCOUNTING 7
6.1 PREMIUMS 7
6.2 PAYMENT
OF PREMIUMS 7
6.3 DELAYED
PAYMENT 7
6.4 FAILURE
TO PAY PREMIUMS 7
6.5 PREMIUM
RATE GUARANTEE 7
REDUCTIONS,
TERMINATIONS AND CHANGES 7
7.1 REDUCTIONS
AND TERMINATIONS 8
7.2 INCREASES 8
7.3 RISK
CLASSIFICATION CHANGES 8
7.4 REINSTATEMENT 8
CONVERSIONS,
EXCHANGES AND REPLACEMENTS 9
8.1 CONVERSIONS 9
8.2 EXCHANGES
AND REPLACEMENTS 9
CLAIMS
9.1 NOTICE
AND CONSULTATION 9
9.2 PROOFS 10
9.3
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AMOUNT
AND PAYMENT OF REINSURANCE BENEFITS109.4
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CONTESTABLE
CLAIMS
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10
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9.5 CLAIM
EXPENSES 11
9.6 MISREPRESENTATION
OR SUICIDE 11
9.7 MISSTATEMENT
OF AGE OR SEX 11
9.8 EXTRA-CONTRACTUAL
DAMAGES 11
CREDIT
FOR RESERVES 11
10.1 RESERVE
METHODOLOGY AND REPORTING 11
RETENTION
LIMIT CHANGES 12
RECAPTURE 12
GENERAL
PROVISION 13
13.1 CURRENCY 13
13.2 PREMIUM
TAX 13
13.3 MINIMUM
CESSION 13
13.4 INSPECTION
OF RECORDS 13
13.5 MEDICAL
INFORMATION BUREAU 13
13.6 GOOD
FAITH 13
13.7 BUSINESS
CONTINUITY 14
DACTAX 14
OFFSET 15
INSOLVENCY 15
16.1 INSOLVENCY
OF A PARTY TO THIS AGREEMENT 15
16.2 INSOLVENCY
OF THE CEDING COMPANY 15
16.3 INSOLVENCY
OF THE REINSURER 15
ERRORS
AND OMMISSIONS 16
DISPUTE
RESOLUTION 16
ARBITRATION 16
CONFIDENTIALITY 17
DURATION
OF AGREEMENT 18
EXECUTION 18
EXHIBITS
A -
Retention Limits of the Ceding Company
B - Plans
Covered and Binding Limits
C -
Forms, Manuals, and Issue Rules
D -
Allocation Rules for Placement of Facultative Cases
E -
Reinsurance Premiums
F -
Conversion Premiums
G -
Self-Administered Reporting
H -
Application for Facultative Reinsurance Form
PREAMBLE
1.1
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PARTIES
TO THE AGREEMENT
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This
is a YRT agreement for indemnity reinsurance (the “Agreement”) solely
between American National Insurance Company of Texas (the “Ceding
Company”), and Swiss Re Life & Health America Inc. of Connecticut (the
“Reinsurer”), collectively referred to as the
“parties”.
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The
acceptance of risks under this Agreement will create no right or legal
relationship between the Reinsurer and the insured, owner or beneficiary
of any insurance policy or other contract of the Ceding
Company.
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The
Agreement will be binding upon the Ceding Company and the Reinsurer and
their respective successors and
assigns.
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1.2 COMPLIANCE
This
Agreement applies only to the issuance of insurance by the Ceding Company in a
jurisdiction in which it is properly licensed.
The
Ceding Company represents that, to the best of its knowledge, it is in
compliance with all state and federal laws applicable to the business reinsured
under this Agreement. In the event that the Ceding Company is found to be in
non-compliance with any law material to this Agreement, the Agreement will
remain in effect and the Ceding Company will indemnify the Reinsurer for any
direct loss the Reinsurer suffers as a result of the noncompliance, and will
seek to remedy the non-compliance.
1.3 CONSTRUCTION
This
Agreement will be in accordance with the laws of the state of
Texas.
1.4 ENTIRE
AGREEMENT
This
Agreement and Exhibits constitute the entire agreement between the parties with
respect to the business reinsured hereunder. There are no understandings between
the parties other than as expressed in this Agreement and Exhibits. In the event
of any discrepancy between the Agreement and the Exhibits, the Exhibits will
control. Any change or modification to this Agreement and Exhibits will be null
and void unless made by amendment to this Agreement and signed by both
parties.
1.5 SEVERABILITY
If any
provision of this Agreement is determined to be invalid or unenforceable, such
determination will not impair or affect the validity or the enforceability of
the remaining provisions of this Agreement.
AUTOMATIC
REINSURANCE
2.1
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GENERAL
CONDITIONS
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On
and after the effective date of this Agreement, the Ceding Company will
automatically cede to the Reinsurer a portion of the life insurance
policies, supplementary benefits, and riders listed in Exhibit B. The
insured, at the time of the application, must be a permanent resident of
the United States or Canada.
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The
Reinsurer will automatically accept its share of the above-referenced
policies up to the limits shown in Exhibit B, provided that to the best of
the Ceding Company's knowledge:
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a.
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the
Ceding Company keeps its full retention, as specified in Exhibit A, or
otherwise holds its full retention on a life under previously issued
inforce policies
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b.
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the
Ceding Company applies its normal underwriting
guidelines
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c.
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the
total of the new ultimate face amount of reinsurance required including
contractual increases, and the amount already reinsured on that life under
this Agreement and all other agreements between the Reinsurer and the
Ceding Company, does not exceed the Automatic Binding Limits set out in
Exhibit B
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d.
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the
total new ultimate face amount of life insurance in force in all
companies, including any coverage to be replaced plus the amount currently
applied for on that life in all companies, does not exceed the Jumbo Limit
stated in Exhibit B, and
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e.
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the
application is on a life that has not been submitted facultatively to the
Reinsurer or any other reinsurer within the last 2 years, unless the
reason for any prior facultative submission was sole for capacity that may
now be accommodated within the terms of this Agreement,
and I
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f.
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other
than as agreed to by the Reinsurer in writing, the Policy is not
purchased, to the knowledge of the Ceding Company, as art of a third party
investment program where such third party lacks an insurable interest in
the insured and where such third party is engaging in insurance
arbitrage.
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For
purposes of this Article "ultimate face amount" will mean the projected maximum
policy face amount that could be reached based on reasonable assumptions made
about the policy.
If the
Ceding Company is already on the risk for its retention under previously issued
policies, the Reinsurer will automatically accept reinsurance for newly issued
policies according to the limits set out in Exhibit A, provided the Ceding
Company has complied with the Forms, Manuals and Issue Rules specified in
Exhibit C, that would have applied if the new policy had fallen completely
within the Ceding Company's retention.
This
Agreement does not cover the following unless specified elsewhere:
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a.
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Noncontractual
conversions, replacements, exchanges or group conversions;
or
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b.
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Policies
issued under a program where full current evidence of insurability
consistent with the amount of insurance is not obtained, or where
conventional selection criteria are not applied in underwriting the risk;
or
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c.
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Any
conversion of a previously issued policy that had been reinsured with
another reinsurer; or
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d.
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Corporate,
bank or other entity owned life insurance programs that are not fully
underwritten.
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Each
reinsured policy must provide for the maximum periods of suicide and
contestability protection permitted by applicable law.
2.2
RETAINED AMOUNTS
The
Ceding Company may not reinsure the amount it has retained on the business
covered under this Agreement, on any basis, without prior notification to the
Reinsurer.
FACULTATIVE
REINSURANCE
3.1
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The
Ceding Company may submit any application on a plan or rider identified in
Exhibit B to the Reinsurer for its consideration on a
facultative basis.
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The
Ceding Company will apply for reinsurance on a facultative basis by sending to
the Reinsurer an Application for Facultative Reinsurance, providing the
information outlined in Exhibit H. Accompanying this Application will be copies
of all underwriting evidence that is available for risk assessment including,
but not limited to, copies of the application for insurance, medical examiners'
reports, attending physicians' statements, inspection reports, and any other
information bearing on the insurability of the risk. The Ceding Company also
will notify the Reinsurer of any outstanding underwriting requirements at the
time of the facultative submission. Any subsequent information received by the
Ceding Company that is pertinent to the risk assessment will be immediately
transmitted to the Reinsurer.
After
consideration of the Application for Facultative Reinsurance and related
information, the Reinsurer will promptly inform the Ceding Company of its
underwriting decision. The Reinsurer's offer will expire at the end of 120 days,
unless otherwise specified by the Reinsurer.
If the
underwriting decision is acceptable, the Ceding Company will notify the
Reinsurer in writing of its acceptance of the offer. If any risk is to be
submitted to more than one reinsurer for consideration, the Allocation Rules for
Placement of Facultative Cases as outlined in Exhibit D will apply.
The
relevant terms and conditions of this Agreement will apply to those facultative
offers made by the Reinsurer and accepted by the Ceding Company.
LIABILITY
The
Reinsurer's liability to the Ceding Company will be based upon the terms of this
Agreement and not the reinsured policy. Unless specified elsewhere in this
Agreement:
a) The
Reinsurer will not participate in any ex gratia payments made by the Ceding
Company i.e., payments the Ceding Company is not required to make under the
policy terms); and
b) The
Reinsurer will not share in any Extra Contractual Obligations (except as set
forth in Article 9.8); and
c) The
Reinsurer's liability is limited to its share of the Ceding Company's
contractual benefits owed under the express terms of the reinsured policies.
Damages or other payments resulting from insolvency and attributable to the
termination or restructure of the reinsured policies are not covered by this
Agreement; and
d) The
Reinsurer will not be liable unless the policy was issued and delivered in
accordance with applicable law nor will the Reinsurer be liable for any payment
prohibited by law.
COMMENCEMENT OF
LIABILITY
4.1 AUTOMATIC
REINSURANCE
For
automatic reinsurance, the Reinsurer's liability will commence at the same time
as the Ceding Company's liability.
4.2 FACULTATIVE
REINSURANCE
For
facultative reinsurance, the Reinsurer's liability will commence at the same
time as the Ceding Company's liability, provided that the Reinsurer has made a
facultative offer and that offer was accepted, in accordance with the terms of
this Agreement.
4.3 CONDITIONAL
RECEIPT OR TEMPORARY INSURANCE
Automatic
reinsurance coverage under a conditional receipt or temporary insurance
provision is limited to the Reinsurer's share of amounts within the Conditional
Receipt or Temporary Insurance Limits specified in Exhibit B. The Reinsurer will
accept liability provided that the Ceding Company has followed its normal
cash-with-application procedures for such coverage.
For
facultative applications submitted to the Reinsurer, the Reinsurer's liability
under a conditional receipt or a temporary insurance agreement will begin
simultaneously with the Ceding Company's contractual liability if the Reinsurer
has received notice from the Ceding Company that the Reinsurer's facultative
offer has been accepted. The Reinsurer's liability is limited to its share, as
shown in Exhibit B, of amounts accepted within the Ceding Company's usual
cash-with-application procedures for temporary coverage, up to the limits shown
in Exhibit B.
If the
proposed insured dies prior to the completion of the underwriting process, the
Reinsurer will continue underwriting the risk to determine if a facultative
offer would have been made on the risk. If so, the Reinsurer will accept
liability for the risk, subject to the limits specified in the paragraph
above.
The
Reinsurer has no liability for facultative applications that the Company has not
submitted to the Reinsurer.
REINSURED RISK
AMOUNT
5.1 LIFE
For
policies with the level death benefit option, the net amount at risk of the
policy is defined as the policy face amount less the reserve. For policies with
the varying death benefit option, the net amount at risk of the policy is
defined as the policy face amount. The reinsured net amount at risk for
automatic policies is determined by multiplying the total net amount at risk on
the policy by the Reinsurer's share as defined in Exhibit B. For variable amount
plans, the net amount at risk is calculated using the reserve at the end of
annual reinsurance billing period. The Ceding Company will maintain a quota
share retention on each policy, up to the maximum limits of its retention per
life for the insured's issue age and rating, as shown in Exhibit A. Risk amounts
above that limit will be reinsured under the terms of this Agreement on an
excess basis.
Any
change in the net amount at risk due to changes in the policy's reserve will be
allocated proportionately between the Ceding Company and the
Reinsurers.
5.2 WAIVER
OF PREMIUM
Not
reinsured.
5.3 ACCIDENTAL
DEATH BENEFIT
Not
reinsured.
PREMIUM
ACCOUNTING
6.1 PREMIUMS
Reinsurance
premium rates for life insurance and other benefits reinsured under this
Agreement are shown in Exhibit E. The rates will be applied to the reinsured net
amount at risk.
The
Ceding Company will pay the Reinsurer the percentages of the premium rates shown
in Exhibit E.
6.2 PAYMENT
OF PREMIUMS
Reinsurance
premiums are payable annually in advance. The Ceding Company will calculate the
amount of reinsurance premium due and, within 30 days after the end of the
month, will send the Reinsurer a statement that contains the information shown
in Exhibit G, showing reinsurance premiums due for that period. If an amount is
due the Reinsurer, the Ceding Company will remit that amount together with the
statement. If an amount is due the Ceding Company, the Reinsurer will remit such
amount within 30 days of receipt of the statement.
6.3 DELAYED
PAYMENT
The
Remittance Date is defined as 30 days after the end of the reporting
period.
6.4 FAILURE
TO PAY PREMIUMS
The
payment of reinsurance premiums is a condition precedent to the liability of the
Reinsurer for reinsurance covered by this Agreement. In the event that
reinsurance premiums are not paid within 60 days of the Remittance Date, the
Reinsurer will have the right to terminate the reinsurance under all policies
having reinsurance premiums in arrears. If the Reinsurer elects to
exercise its right of termination after such 60 day period, it will give the
Ceding Corn any 15 days prior written notice of its intention. Such notice will
be sent by certified mail.
If all
reinsurance premiums in arrears, including any that become in arrears during the
15 day notice period are not paid before the expiration of the notice period,
the Reinsurer will be relieved of all liability under those policies as of the
last date to which premiums have been paid for each. Reinsurance on policies on
which reinsurance premiums subsequently fall due will automatically terminate as
of the Iast date to which premiums have been paid for each policy, unless
reinsurance premiums on those policies are paid on or before their Remittance
Dates.
If
reinsurance is termninated according to this Article, unearned premiums, net of
outstanding balances, will be paid by the party with the positive
balance.
Terminated
reinsurance maybe reinstated, subject to approval by the Reinsurer, within 30
days of the date of termination, and upon payment of all reinsurance premiums in
arrears including any interest accrued thereon. The Reinsurer will have no
liability for any claims incurred between the date of termination and the date
of the reinstatement of the reinsurance. The right to terminate reinsurance will
not prejudice the Reinsurer's right to collect premiums and interest due for the
period during which reinsurance was in force prior to the expiration of the 15
days notice.
The
Ceding Company will not force termination under the provisions of this Article
solely to avoid the provisions regarding recapture in Article 12, or to transfer
the reinsured policies to another reinsurer.
6.5
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PREMIUM
RATE GUARANTEE
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While it
is not anticipated that the Reinsurer will raise its rates, the YRT reinsurance
rates set out in this sub-section are guaranteed to the extent that in the 2
nd year
and later the Reinsurer reserves the right to increase the premiums for
reinsurance but not above the statutory net premium.
If the
Reinsurer exercises its rights to increase reinsurance premiums under this
Agreement in an amount greater than that required to ensure that the Reinsurer
will participate in the Reinsurer's share of any increases in premium rates,
costs, charges or fees as implemented by the Company with respect to the
Reinsured Policies, the Company may recapture the Reinsured Policies as to which
reinsurance rates have been increased regardless of the Reinsured Policies'
duration in force. If the Ceding Company elects to recapture reinsurance under
this provision, unearned premiums, net of outstanding balances, will be
calculated and paid by the party with the positive balance.
REDUCTIONS, TERMINATIONS AND
CHANGES
Whenever
a change is made in the status, plan, amount or other material feature of a
policy reinsured under this Agreement, the Reinsurer will, upon receipt of
notification of the change, provide adjusted reinsurance coverage in accordance
with the provisions of this Agreement. The Ceding Company will notify the
Reinsurer of any such change within 60 days of its effective date.
7.1
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REDUCTIONS
AND TERMINATIONS
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In the
event of the reduction, lapse, or termination of a policy or policies reinsured
under this Agreement or any other agreement, the Ceding Company will reduce or
terminate reinsurance on that life. The reinsured amount on the life with all
reinsurers will be reduced, effective on the same date, by the amount required
such that the Ceding Company maintains its retention as defined under this
Agreement.
The
reinsurance reduction will apply first to the policy or policies being reduced
and then, on a chronological basis, to other reinsured policies on the life,
beginning with the oldest policy. If a fully retained policy on a life that is
reinsured under this Agreement is terminated or reduced, the Ceding Company will
reduce the existing reinsurance on that life by a corresponding amount, with the
reinsurance on the oldest policy being reduced first. If the amount of reduction
exceeds the risk amount reinsured, the reinsurance on the policy or policies
will be terminated.
If the
reinsurance for a reinsured policy has been placed with more than one reinsurer,
the reduction will be applied to all reinsurers pro rata to the amounts
originally reinsured with each reinsurer.
A
reduction to one of the Ceding Company's policies not reinsured hereunder will
require that the Ceding Company's retention be increased to its full
retention.
7.2
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INCREASES
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a.
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Noncontractual
Increases
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If the
amount of insurance is increased as a result of a noncontractual change, the
increase will be underwritten by the Ceding Company in accordance with its
customary standards and procedures and will be considered new reinsurance under
this Agreement. The Reinsurer's approval is required if the original policy was
reinsured on a facultative basis or if the new amount will cause the reinsured
amount on the life to exceed either the Automatic Binding Limits or the Jumbo
Limits shown in Exhibit B.
The
Ceding Company and the Reinsurer will share the increased amount
proportionately. Once the Ceding Company's maximum retention has been reached,
the remaining amount will be reinsured on an excess basis.
b. Contractual
Increases
For
policies reinsured on an automatic basis, reinsurance of increases in amount
resulting from contractual policy provisions will be accepted only up to the
Automatic Binding Limits shown in Exhibit B.
For
policies reinsured on a facultative basis, reinsurance will be limited to the
ultimate amount shown in the Reinsurer's facultative offer. Reinsurance premiums
for contractual increases will be on a point-in-scale basis from the original
issue age of the policy.
7.3 RISK
CLASSIFICATION CHANGES
If the
policyholder requests a Table Rating reduction or removal of a Flat Extra, such
change will be underwritten according to the Ceding Company's normal
underwriting practices. Risk classification changes on facultative policies will
be subject to the Reinsurer's approval. Reinsurance premiums for the revised
risk classification will be on a point-in-scale basis from the original issue
age of the policy.
7.4 REINSTATEMENT
If a
policy reinsured on an automatic basis is reinstated in accordance with its
terms and in accordance with Ceding Company rules and procedures, the Reinsurer
will, upon notification of reinstatement reinstate the reinsurance coverage. The
Reinsurer's approval is required for the reinstatement of a facultative policy
if the Ceding Company's regular reinstatement rules indicate that evidence of
insurability, in addition to a statement good health, is required. Upon
reinstaternent of the reinsurance coverage, the Ceding Company will pay the
contractual reinsurance premiums plus accrued interest for the period and at the
interest rate which it receives on premiums in arrears.
CONVERSIONS, EXCHANGES AND
REPLACEMENTS
If a
policy reinsured under this Agreement is converted, exchanged or replaced, the
Ceding Company will promptly notify the Reinsurer as specified in Exhibit G.
Unless mutually agreed otherwise, policies that are not reinsured with the
Reinsurer and that exchange or convert to a plan covered under this Agreement
will not be reinsured hereunder.
8.1 CONVERSIONS
The
Reinsurer will continue to reinsure policies resulting from the contractual
conversion of any policy reinsured under this Agreement, in an amount not to
exceed the original amount reinsured hereunder. If the plan to which the
original policy is converting is reinsured by the Reinsurer, either under this
Agreement or under a different Agreement, reinsurance premium rates for the
resulting converted policy wilI be those contained in the Agreement that covers
the pIan to which the original policy is converting. However, if the new plan is
not reinsured by the Reinsurer, reinsurance premiums for a policy resulting from
a contractual conversion will use the rates shown in Exhibit F. Reinsurance
premiurns and any allowances for conversions will be on a point-in-scale basis
from the original issue age of the policy.
If the
conversion results in an increase in the risk amount, the increase will be
underwritten by the Ceding Company in accordance with its customary standards
and procedures. The Reinsurer will accept its share of such increases, subject
to the new business provisions of this Agreement. Reinsurance premiums and any
allowances for increased risk amounts will be first-year premiurns at the
agreed-upon premium rate.
8.2 EXCHANGES
AND REPLACEMENTS
A policy
resulting from an internal exchange or replacement will be underwritten by the
Ceding Company in accordance with its underwriting guidelines, standards and
procedures for exchanges and replacements. If the Ceding Company's guidelines
treat the policy as new business, then the reinsurance will also be considered
new business. For purposes of this Article, new business is defined as those
policies on which:
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a.
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the
Ceding Company has obtained complete and current underwriting evidence on
the full amount; and
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b.
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the
full normal commissions are paid for the new plan;
and
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c.
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the
Suicide and Contestable provisions apply as if the policy were newly
issued.
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The
Reinsurer's approval to exchange or replace the policy will be required if the
original policy was reinsured on a facultative basis.
If the
Ceding Company's guidelines do not treat the policy as new business, the
exchange or replacement will continue to be ceded to the Reinsurer. The rates
will be based on the original issue age, underwriting class and duration since
the issuance of the original policy.
CLAIMS
Claims
covered under this Agreement include only death claims, which are those due to
the death of the insured on a policy reinsured under this Agreement, and any
additional benefits specified in Exhibit B, which are provided by the underlying
policy and are reinsured under this Agreement.
9.1 NOTICE
AND CONSULTATION
The
Ceding Company is responsible for the settlement of claims in accordance with
applicable law and policy terms. For purposes of this Article, Reinsured
Policies include conditional receipts and temporary insurance agreements covered
under the terms of this Agreement. It is a condition to the Reinsurer's
obligation to pay a claim that the Ceding Company notify the Reinsurer in
writing as soon as possible, but in any event not later than 12 months, after
the Ceding Company receives notice of a clairn on a Reinsured Policy. The Ceding
Company will promptly provide the Reinsurer with copies of all claims
documents.
As a
condition to the Reinsurer's obligation to pay a claim, before making a claim
decision or settlement offer, the Ceding Company will seek the Reinsurer's
recommendation on such matters to the extent specified in Exhibit E. The
Reinsurer will make a recommendation within 7 business days. If the Reinsurer
does not respond within 7 business days, then it will be deemed that the
Reinsurer is in agreement with the Ceding Company's decision. The terms of
Exhibit E notwithstanding, the Ceding Company may request a recommendation from
the Reinsurer on any claim on a Reinsured Policy. The Ceding Company will
provide the Reinsurer all information, including underwriting files, requested
by the Reinsurer for consideration of any claim on a Reinsured
Policy.
The
Ceding Company, if notified, will notify the Reinsurer of deaths that do not
trigger policy benefits.
9.2 PROOFS
The
Ceding Company will promptly provide the Reinsurer with proper claim proofs,
including a copy of the proof of payment by the Ceding Company, and a copy of
the insured's death certificate. In addition, for contestable claims, the Ceding
Company will send to the Reinsurer a copy of all papers in connection with the
claim.
9.3 AMOUNT
AND PAYMENT OF REINSURANCE BENEFITS
As soon
as the Reinsurer receives proper claim notice and proof of the claim, the
Reinsurer will promptly pay the reinsurance benefits due the Ceding Company. The
Reinsurer will be liable to the Ceding Company for its share of the benefits
reinsured under this Agreement. The total reinsurance recoverable from all
companies will not exceed the Ceding Company's total contractual liability on
the policy, less the amount retained. The maximum reinsurance death benefit
payable to the Ceding Company under this Agreement is the risk amount
specifically reinsured with the Reinsurer. The Reinsurer will also pay its
proportionate share of the interest that the Ceding Company pays on the death
proceeds until the date of settlement.
Life
benefit payments will be made in a single sum, regardless of the Ceding
Company's settlement options.
The
Company is responsible for the investigating, contesting, compromising or
litigating any Reinsured Policy claims in accordance with applicable law and
policy terms. It is the Company's sole decision to determine whether to
investigate, contest, compromise or litigate a claim.
The
Company acknowledges that it follows industry standard and investigates claims
with any of the following criteria:
a) If
the claim occurs within the contestable period as defined by the Reinsured
Policy; or
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b)
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If
there is a reasonable question regarding the validity of the insured's
death or the authenticity of the proofs of death;
or
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c) If
the death occurs outside the United States or Canada; or
d) If
the insured is missing or presumed dead; or
e) If
there is a reasonable suspicion of fraud.
A claim
investigation generally includes confirming proof of death, medical records to
validate the insured's medical disclosures and, if material, financial condition
at the time of Policy application. Investigations may also include obtaining
police reports, coroner's reports, financial records, or other information that
would be appropriate under the circumstances.
The
Company acknowledges that it does defend against claims meeting the following
criteria:
f) If
a material misrepresentation is found in the Policy application; or
g) If
fraud is found-, or
h) If
there is insufficient proof of death.
9.4 CONTESTABLE
CLAIMS
The
Ceding Company will promptly notify the Reinsurer of its intention to contest,
compromise., or litigate a claim involving a reinsured policy in accordance with
the procedures shown in Exhibit E. The Ceding Company will provide the Reinsurer
all relevant information and documents as such become available, pertaining to
Contestable Claims and will promptly report any developments during the
Reinsurer's review. The Reinsurer will have 7 business days to notify the Ceding
Company, in writing, of its decision to accept or reject participation in the
contest, compromise, or litigation upon receipt of all documents provided and
information which may be requested. If the Reinsurer does not respond within 7
business days it is deemed to have accepted participation in the contest,
compromise, or litigation.
If the
Reinsurer does not accept participation, the Reinsurer will then fulfill its
obligation by paying the Ceding Company its full share of the reinsurance
amount, and will not stare in any subsequent reduction or increase in
liability.
If the
Reinsurer accepts participation and the Ceding Company's contest, compromise, or
litigation results in a reduction or increase in liability, the Reinsurer will
share in any such reduction or increase in proportion to its share of the risk
on the contested policy.
If the
Reinsurer has accepted participation, the Ceding Company will promptly advise
the Reinsurer of all significant developments in the claim investigation,
including notification of any legal proceedings against it in response to denial
of the claim.
9.5 CLAIM
EXPENSES
The
Reinsurer will pay its share of reasonable claim investigation and legal
expenses connected with the litigation or settlement of contractual liability
claims unless the Reinsurer has discharged its liability pursuant to Section 9.4
above. If the Reinsurer has so discharged its liability, the Reinsurer will not
participate in any expenses incurred thereafter.
The
Reinsurer will not reimburse the Ceding Company for routine claim and
administration expenses, including but not limited to the Ceding Company's home
office expenses, compensation of salaried officers and employees, and any legal
expenses other than third party expenses incurred by the Ceding Company. Claim
investigation expenses do not include expenses incurred by the Ceding Company as
a result of a dispute or contest arising out of conflicting claims of
entitlement to policy proceeds or benefits.
9.6 MISREPRESENTATION
OR SUICIDE
If the
Ceding Company returns premium to the policyowner or beneficiary as a result of
misrepresentation, tile Reinsurer will refund net reinsurance premiums received
on that policy without interest to the Ceding Company in lieu of any other form
of reinsurance benefit payable under this Agreement. If the Ceding Company pays
an amount equal to the return of premium to a policy owner or beneficiary as a
result of suicide of the insured, the Reinsurer will refund the net reinsurance
premiums received on that policy with its proportional share of any interest
that the Ceding Company may have paid to the policy owner or
beneficiary.
9.7 MISSTATEMENT
OF AGE OR SEX
In the
event of a change in the amount of the Ceding Company's liability on a reinsured
policy due to a misstatement of age or sex, the Reinsurer's liability will
change proportionately. The face amount of the reinsured policy will be adjusted
from the inception of the policy, and any difference will be settled without
interest.
9.8 EXTRA-CONTRACTUAL
DAMAGES
For
purposes of this Agreement, "Extra Contractual Obligations" are any obligations
or expenses other than contractual obligations incurred by the Ceding Company,
its affiliates, directors, officers, employees, agents or other representatives
and arising under the express written terms and conditions of a policy,
including but not limited to, punitive damages, bad faith damages compensatory
damages, and other damages or fines or penalties which may arise from the acts,
errors or omissions of the Ceding Company or its affiliates, directors,
officers, employees, agents or other representatives.
The
Reinsurer is not liable for Extra Contractual Obligations associated with a
Contested Claim unless it concurred in writing and in advance with the claim
actions which were the basis for the Extra Contractual Obligations. In these
situations, the Ceding Company and the Reinsurer will share in Extra Contractual
Obligations, in equitable proportions, but all factors being equal, the
Reinsurer's assessments would be in proportion to the risk accepted for the
Reinsured Policy involved.
The
Reinsurer will not be liable for any Extra Contractual Obligations incurred as a
result of actions taken by the Ceding Company, its affiliates, directors,
officers, employees, agents or other representatives in carrying out any claims
action agreed upon by the Ceding Company and the Reinsurer.
CREDIT FOR
RESERVES
10.1 RESERVE
METHODOLOGY AND REPORTING
The
parties intend that the Ceding Company will receive full statutory reserve
credit in its state of domicile for the insurance risks ceded to the Reinsurer.
The parties agree to make all reasonable efforts to ensure that this is
accomplished.
The
Ceding Company will provide a reserve summary for business reinsured under this
agreement to the Reinsurer on an annual basis, along with a detailed description
of its reserving assumptions and any changes in
these
assumptions applicable to each calendar year.
NON-WAIVER;
RETROCESSION
A waiver
by either party of any violation, or the default by the other party in its
adherence to any term of this Agreement, will not constitute a waiver of any
other or subsequent violation or default. No prior transaction or dealing
between the parties will establish any custom or usage waiving or modifying any
provision of the Agreement. The failure of either party to enforce any part of
this Agreement will not constitute a waiver of any right to do so.
The
Reinsurer may reinsure or retrocede any risks or business assumed hereunder, but
may not effect any novation of this Agreement without the Ceding Company's prior
written consent.
RETENTION LIMIT
CHANGES
11.1
|
If
the Ceding Company changes its maximum retention limits as shown in
Exhibit A, it will provide the Reinsurer with written notice of the
intended changes ninety (90) days in advance of their effective
date.
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A change
to the Ceding Company's maximum retention limits will not affect the reinsured
policies in force at the time of such change except as specifically provided
elsewhere in this Agreement. Furthermore, unless agreed between the parties, an
increase in the Ceding Company's retention schedule will not effect an increase
in the total risk amount that it may automatically cede to the
Reinsurer.
If the
Ceding Company decreases its Retention Limit, no reinsurance may be ceded on an
automatic basis until the parties have reviewed and either expressly affirmed or
revised the Automatic Binding Limits set out in Exhibit B.
RECAPTURE
12.1
|
Not
more than once in any consecutive twenty-four month period, the Ceding
Company may apply its increased maximum retention limits to reduce the
amount of in force Reinsured Policies
provided.
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The
Ceding Company gives the Reinsurer irrevocable written notice of its intention
to recapture within 90 days of the effective date of the maximum retention limit
increase; and
Such
recaptures are made on the next anniversary of each Reinsured Policy affected
unless mutually agreed otherwise by the Ceding Company and the Reinsurer and
with no recapture being made until the Reinsured Policy has been in force for
the period stated in Exhibit E.4. For a conversion or re-entry, the recapture
terms of the original policy will apply and the duration for the recapture
period will be measured from the effective date o t e original policy;
and
The
Ceding Company has maintained from the time the policy was issued, its full
retention as set out in Exhibit A for the plan and the insured's classification;
and
The
Ceding Company has applied its increased Retention Limits in a consistent manner
to all categories of its Retention Limits set out in Exhibit A unless otherwise
agreed to by the Reinsurer, and
Other
than as respects bona fide catastrophe or financial reinsurance arrangements,
the Ceding Company will retain all risks so recaptured and is prohibited from
ceding in any form any of the recaptured business without the Reinsurer's prior
written consent.
In
applying its increased Retention Limits to Reinsured Policies, the age and
mortality rating at the time of issue will be used to determine the amount of
the Ceding Company s increased maximum retention. The amount of reinsurance
eligible for recapture will be the difference between the amount originally
retained and the amount the Ceding Company would have retained on the same quota
share basis had the new retention been in effect at the time of issue. If there
is reinsurance with other companies on risks eligible for recapture, the
necessary reduction is to be applied pro rata to the total outstanding
reinsurance.
Recapture
as provided herein is optional with the Ceding Company, but if any Reinsured
Policy is recaptured, all Reinsured Policies eligible for recapture under the
provisions of this Article must be similarly recaptured as well as all eligible
life risks reinsured under any other reinsurance agreement in force between, on
one hand, the Reinsurer and, on the other hand, the Ceding Company or any common
retention affiliate thereof as to which any recapture rights may then be
available to the Ceding Company or such affiliate. For purposes of this
provision, the term "common retention affiliate" means any affiliate of the
Ceding Company as to which corporate mortality risk retention levels have been
managed on a coordinated basis with the Ceding Company's risk retention
program.
The
Ceding Company may not revoke its election to recapture for Reinsured Policies
becoming eligible at future anniversaries.
No
recapture of Reinsured Policies will occur if the Ceding Company has either
obtained or increased stop loss reinsurance coverage as justification for the
increase in maximum retention.
The
Reinsurer will not be liable, after the effective date of recapture, for any
Reinsured Policies or portions of such Reinsured Policies eligible for recapture
that the Ceding Company has overlooked. The Reinsurer will I be liable only for
a credit of the premiums, received after the recapture date, less any allowance.
The parties' obligations for any recaptured business will be limited to those
relating to events or circumstances arising or occurring before the recapture
date.
The terms
and conditions for the Ceding Company to recapture in force Reinsured Policies
due to the insolvency of the Reinsurer are set out in the Insolvency clause in
Article 16.3.
If the
Ceding Company transfers business which is reinsured under this Agreement to a
successor company, then the successor company has the option to recapture the
reinsurance, in accordance with the recapture criteria outlined in this Article,
only if the successor company has or adopts a higher retention Iii-nit than the
Ceding Company.
Upon
recapture each party will be deemed to be fully and finally released from all
obligations under this Agreement with respect to the recaptured
business.
GENERAL
PROVISION
13.1 CURRENCY
All
payments and reporting by both parties under this Agreement will be made in
United States dollars.
13.2 PREMIUM
TAX
The
Reinsurer will not reimburse the Ceding Company for premium taxes.
13.3 MINIMUM
CESSION
The
Ceding Company will not cede a policy to the Reinsurer unless the amount to be
reinsured at issue exceeds the Initial Minimum Cession amount shown in Exhibit
B.
Reinsurance
will be cancelled on any policy when its reinsured net amount at risk falls
below the Trivial Amount limit shown in Exhibit B.
13.4 INSPECTION
OF RECORDS
The
Reinsurer or its duly appointed re representative will have access to records of
the Ceding Corn any, whether written or electronic, and including system view
access, concerning the business reinsured hereunder for the purpose of
inspecting, auditing and photocopying those records. Such access will be
provided at the office of the Ceding Company and will be during reasonable
business hours. Assuming the Reinsurer has continued to perform the undisputed
portion of its obligations under this Agreement, the Ceding Company may not
withhold access to information and records on the rounds that the Reinsurer is
in breach. The Reinsurer's right of access as specified above will survive until
all of the Reinsurer's obligations Xxxxxx this Agreement have terminated or been
fully discharged.
13.5 MEDICAL
INFORMATION BUREAU
It is the
Ceding Company's responsibility to ensure that its practice and applicable forms
are in compliance with current Medical Information Bureau (MIB)
guidelines.
13.6 GOOD
FAITH
All
matters with respect to this Agreement require the utmost good faith of both
parties.
Each
party represents and warrants to the other party that it is solvent on a
statutory basis in all states in which it does business or is
licensed.
The
Reinsurer has entered into this Agreement in reliance upon the Company's
representations and warranties. The Company affirms that it has and will
continue to disclose all matters material to this Agreement. Examples of such
matters are a change in underwriting or issue practices or philosophy, a change
in underwriting or claims management personnel, or changes in the Ceding
Company's ownership or control.
The
Company affirms that the underwriting, administration and claims practices it
employs are consistent with the customary and usual practices of the insurance
industry as a whole. Should the Company engage in exceptional or uncustomary
practices, it will inform the Reinsurer of such action and obtain its written
consent before assigning any liability to the Reinsurer with respect to any
policies covered under this Agreement.
13.7 Business
Continuity
All
reinsured policies will be issued and administered in accordance with the Forms,
Manuals and Issue Rules specified in Exhibit C. The parties acknowledge that
changes to or failure to comply with the Forms, Manuals and Issue Rules
specified in Exhibit C, may materially affect the Reinsurer's experience under
this Agreement. Therefore, the Ceding Company will notify the Reinsurer of any
change that materially affects the reinsured business, including changes to the
Forms, Manuals and Issue Rules specified in Exhibit C. This Agreement will not
cover policies affected by such changes unless the Reinsurer has agreed in
writing and in advance to accept the affected policies. Outsourcing of
underwriting functions, administrative functions or claims administration with
respect to the reinsured policies will be considered a material change. If the
Reinsurer agrees to accept policies affected y the outsourcing, the Ceding
Company will secure the Reinsurer's right to audit and inspect the party
performing such outsourced services.
In the
event the Ceding Company makes a change that materially affects the reinsured
business, including changes to the Forms, Manuals and Issue Rules specified in
Exhibit C, without the Reinsurer's consent to accept the affected
policies:
|
a)
|
The
parties will attempt to negotiate revised terms as necessary under which
the affected reinsured policies may continue to be reinsured;
and
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|
b)
|
If
the parties are unable to agree on revised terms within 120 days, any
reinsured policies materially and adversely affected by the change will be
excluded from coverage under this
Agreement.
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If
reinsured policies are excluded, the parties will make returns of Agreement Cash
Settlements previously made in connection with the subject reinsured policies,
For purposes of this Agreement, the term "Agreement Cash Settlements" will mean
premiums, allowances, commissions, cash surrender values, death claims
dividends, experience refund payments and similar settlements made under this
Agreement, but excludes items relating to reserves or interest on
reserves.
DAC TAX
14.1
|
The
parties to this Agreement agree to the following provisions pursuant to
Section 1.848-2(g)(8) of the Income Tax Regulations effective December 29,
1992, under Section 848 of the Internal Revenue Code of 1986, as
amended:
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|
a.
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The
term 'party' refers to either the Ceding Company or the Reinsurer, as
appropriate.
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|
b.
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The
terms used in this Article are defined by reference to Regulation Section
1.948-2, effective December 29,
1992.
|
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c.
|
The
party with the net positive consideration for this Agreement for each
taxable year will capitalize specified policy acquisition expenses with
respect to this Agreement without regard to the genera deductions
limitation of Section 848(c)(1).
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|
d.
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Both
parties agree to exchange information pertaining to the amount of net
consideration under this Agreement each year to ensure consistency, or as
otherwise required by the Internal Revenue Service. If requested, the
Ceding Company will provide supporting information reasonably requested by
the Reinsurer. (The term "net consideration" means "net consideration" as
defined in Regulation Section
1.848-2(f));
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|
e.
|
This
DAC Tax Election will be effective for the first taxable year in which
this Agreement is effective and for all years for which this Agreement
remains in effect. The Ceding Company and the Reinsurer will each attach a
schedule to their respective federal income tax returns filed for the
first taxable year for which this DAC Tax Election is effective. Such
schedule will identify the Agreement as a reinsurance agreement for which
the DAC Tax Election under Regulation Section 1.848.2(g)(8) has been
made.
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f.
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Both
the Ceding Company and the Reinsurer represent and warrant that they are
subject to United States taxation under either Subchapter L or Subpart F
of Part III of Subchapter N of the Internal Revenue Code of 1986, as
amended.
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OFFSET
15.1
|
Any
debts or credits, in favor of or against either the Reinsurer or the
Ceding Company with respect to is Agreement or any other reinsurance
agreement between the parties, are deemed mutual debts or credits and may
be offset, and only the balance will be allowed or
paid.
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The right
of offset will not be affected or diminished because of the insolvency of either
party.
INSOLVENCY
16.1 INSOLVENCY
OF A PARTY TO THIS AGREEMENT
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A
party to this Agreement will be deemed insolvent when
it:
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|
a
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applies
for or consents to the appointment of a receiver, rehabilitator,
conservator, liquidator or statutory successor of its properties or
assets; or
|
|
b
|
is
adjudicated as bankrupt or insolvent;
or
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|
c.
|
files
or consents to the filing of a petition in bankruptcy, seeks
reorganization to avoid insolvency or makes formal application for any
bankruptcy, dissolution, liquidation, conservation or similar law or
statute; or
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|
d.
|
becomes
the subject of an order to rehabilitate or an order to liquidate as
defined by the insurance code of the jurisdiction of the party's
domicile.
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16.2 INSOLVENCY
OF THE CEDING COMPANY
In the
event of the insolvency of the Ceding Company, all reinsurance payments due
under this Agreement will be payable directly to the liquidator, rehabilitator,
receiver, or statutory successor of the Ceding Company, without diminution
because of the insolvency, for those claims allowed against the Ceding Company
by any court of competent jurisdiction or by the liquidator, rehabilitator,
receiver or statutory successor having authority to allow such
claims.
In the
event of insolvency of the Ceding Company, the liquidator, rehabilitator,
receiver, or statutory successor will give written notice to the Reinsurer of
all pending claims against the Ceding Company on any policies reinsured within a
reasonable time after such claim is filed in the insolvency proceeding. While a
claim is pending, the Reinsurer may investigate and interpose, at its own
expense, in the proceeding where the claim is adjudicated, any defense or
defenses that it may deem available to the Ceding Company or its liquidator,
rehabilitator, receiver, or statutory successor.
The
expense incurred by the Reinsurer will be chargeable, subject to court approval,
against the Ceding Company as part of the expense of its insolvency proceedings
to the extent of a proportionate share of the benefit that may accrue to the
Ceding Company solely as a result of the defense undertaken by the Reinsurer.
Where two or more reinsurers are participating in the same claim and a majority
in interest elect to interpose a defense or defenses to any such claim. the
expense will It be apportioned in accordance with the terms of this Agreement as
though such expense had been incurred by the Ceding Company.
The
Reinsurer will be liable only for benefits reinsured as benefits become due
under the tern-is of the reinsured policies and will not be or become liable for
any amounts or reserves to be held by the Ceding Company as to the reinsured
policies or for any damages or payments resulting from the termination or
restructure of the policies that are not otherwise covered by this
Agreement.
16.3 INSOLVENCY
OF THE REINSURER
In the
event of the insolvency of the Reinsurer, the Ceding Company may cancel this
Agreement for new business by promptly providing the Reinsurer, its receiver,
rehabilitator, conservator, liquidator or statutory successor with written
notice of the cancellation effective the date on which the Reinsurer's
insolvency is established by the authority responsible for such determination.
Any requirement for a notification period prior to the cancellation of the
Agreement would not apply under such circumstances.
In
addition, the Ceding Company may provide the Reinsurer, its receiver,
rehabilitator, conservator, liquidator or statutory successor with written
notice of its intent to recapture all reinsurance in force under this Agreement
regardless of the duration the reinsurance has been in force or the amount
retained by the Ceding Company on the policies reinsured hereunder. The
effective date of a recapture due to insolvency would be at the election of the
Ceding Company and would not be earlier than the date on which the Reinsurer's
insolvency is established by the authority responsible for such determination.
If the Ceding Company elects to terminate reinsurance under this Article,
unearned premiums net of outstanding balances, will be paid by the party with
the positive balance.
ERRORS AND
OMISSIONS
17.1
|
Any
unintentional or accidental failure to comply with the terms of this
Agreement which can be shown to be the result of an oversight or clerical
error relating to the administration of reinsurance by either party will
not constitute a breach of this Agreement. Upon discovery, the error will
be promptly corrected so that both parties are restored to the position
they would have occupied had the oversight or clerical error not occurred.
In the event a payment is corrected, the party receiving the payment may
charge interest calculated according to the terms specified in Exhibit E.
If it is not possible to restore both parties to this position, the party
responsible for the oversight or clerical error will be responsible for
any resulting liabilities and expenses. The Reinsurer will not provide
reinsurance for policies that do not satisfy the parameters of this
Agreement, nor will the Reinsurer be responsible for negligent or
deliberate acts or for repetitive errors in administration by the Ceding
Company.
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|
If
either party discovers that the Ceding Company has failed to cede
reinsurance as provided in this Agreement, or failed to comply with its
reporting requirements, the Reinsurer may require the Ceding Company to
audit its records for similar errors and to take the actions necessary to
avoid similar errors in the future.
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DISPUTE
RESOLUTION
18.1
|
In
the event of a dispute arising out of or relating to this agreement, the
parties agree to the following process of dispute resolution. Within 15
days after the Reinsurer or the Ceding Company has first given the other
party written notification of a specific dispute, each party will appoint
a designated company officer to attempt to resolve the dispute. The
officers will meet at a mutually agreeable location as soon as possible
and as often as necessary, in order to gather and furnish the other with
all appropriate and relevant information concerning the dispute. The
officers will discuss the problem and will negotiate in good faith without
the necessity of any formal arbitration proceedings. During the
negotiation process, all reasonable requests made by one officer to the
other for information will be honored. The designated officers will decide
the specific format for such
discussions.
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|
If
the officers cannot resolve the dispute within 30 days of their first
meeting, the dispute will be submitted to formal arbitration, unless the
parties agree in writing to extend the negotiation period for an
additional 30 days.
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ARBITRATION
19.1
|
If
the Ceding Company and Reinsurer are unable to resolve any dispute arising
from this Agreement, including but not limited to the formation or breach
thereof, pursuant to Article 18. 1, the matter will be referred to
arbitration.
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The
arbitration will be conducted in accordance with the Procedures for Resolution
of U.S. Insurance and Reinsurance Disputes, Neutral Panel Version, April 2004
(the "Procedures") available at xxx.xxxxxxxxxxxxxxxxxxxx.xxx, except as modified
herein.
The
arbitration will be held in Galveston, Texas or another place as the parties may
mutually agree. The arbitration will be conducted before a three person Panel
qualified as:
a) Current
or former officers of life insurance or reinsurance companies, or
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b)
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Professionals
with no less than 10 years of experience in or serving the life insurance
or reinsurance industries.
|
The
parties will select such candidates from the XXXXX-US Certified Arbitrators List
available at
xxx.XXXXX-XX.xxx.
The
customs and practices of the life insurance and reinsurance industries may be
considered by the Panel to resolve any ambiguities in the Agreement but only
insofar as such customs and practices are consistent with a strict construction
of the terms of this Agreement. The Panel will not have the authority to award
punitive or exemplary damages
The Panel
will award the remedy sought by the party seeking relief to the extent the
remedy is provided for in this Agreement or otherwise reasonably compensates the
damaged party for the economic effect of any demonstrated breach. Such remedies
may include, but will not be limited to, monetary damages, revisions to the
terms of the Agreement, including adjustments to premiums or allowances paid or
to be paid, or any combination of the foregoing.
The Panel
shall issue an order. appropriate for confirmation in a court of competent
jurisdiction, to resolve all matters in dispute. In addition, the Panel shall
issue a written opinion setting forth the reasons for the award, with citations
to the record of the hearing that support the reasoning.
The
decision of the Panel will be final and binding upon the parties and their
respective successors and assigns. Each party hereby consents to the entry of a
judgment confirming or enforcing the award in any court of competent
jurisdiction.
Within 20
days after the transmittal of an award, either party, upon notice to the other
party, may request the Panel to correct any clerical, typographical, or
computational errors in the award. The other party will be given ten days to
respond to the request. The Panel will dispose of the request within 20 days of
its receipt of such request and any response thereto. The Panel will not be
empowered to re-determine the merits of any claim already decided.
Each
party will:
|
c)
|
Bear
its own fees and expenses in connection with the arbitration, including
the fees of any outside counsel and witness fees,
and
|
|
d)
|
Share
equally in the fees for the members of the Panel and the costs of the
arbitration, such as hearing rooms court reporters,
etc.
|
It is the
intent of the parties that these arbitration provisions replace and be in lieu
of any statutory arbitration provision, if permitted by law.
CONFIDENTIALITY
20.1
|
Reinsurer
hereby acknowledges that from time to time in the performance of its
duties and obligations under the Agreement, Reinsurer may receive certain
information about policyholders or certificateholders of Insurer that may
be characterized as "Nonpublic Personal Information" under Title V of the
federal Xxxxx- Xxxxx -Xxxxxx Act and/or state insurance laws and/or
regulations enacted and/or promulgated in accordance therewith
(collectively the "Privacy Act"). "Nonpublic Personal Information"
includes any personally identifiable financial and/or health information
about Insurer's customers and any list, description or other grouping of
customers that is derived using any personally identifiable information
that is not publicly available.
|
Reinsurer
and Insurer hereby acknowledge and agree that they are "nonaffiliated third
parties" with respect to one another for purposes of the Privacy Act. Reinsurer
and Insurer further acknowledge and agree that Insurer's disclosure of nonpublic
personal information to Reinsurer under this Agreement is made under one or more
exceptions to the Privacy Act's opt-out or opt-in requirements. Reinsurer agrees
not to disclose the nonpublic personal information received from Insurer to any
other person or to use the nonpublic personal information received pursuant to
this Agreement except: (1) as necessary in the ordinary course of business in
order to carry out Reinsurer's obligations under this Agreement; or (2) as
allowed under a recognized exception or permitted redisclosure under the Privacy
Act. This provision shall survive the termination of this
Agreement.
20.2
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The
Ceding Company and the Reinsurer agree that Proprietary Information will
be treated as confidential. Proprietary Information includes, but is not
limited to, business plans and trade secrets, mortality and lapse studies,
underwriting manuals and guidelines, applications and contract forms, and
the specific terms and conditions of this
Agreement.
|
Proprietary
Information will not include information that:
|
a.
|
is
or becomes available to the general public through no fault of the party
receiving the Proprietary Information (the
"Recipient");
|
b. is
independently developed by the Recipient;
c. is
acquired by the Recipient from a third party not covered by a confidentiality
agreement; or
d. is
disclosed under a court order, law or regulation.
The
parties will not disclose such information to any other parties unless the
disclosure is, in the reasonable judgment of either Party, required or deemed
advantageous (in terms of pricing, ease of execution or other-wise) for the
purpose of any reinsurance, retrocession, securitization, or structured,
asset-backed or asset-based financing, as requested by external auditors, as
required by court order, or as required or allowed by law or
regulation.
The
Ceding Company acknowledges that the Reinsurer can aggregate data with other
companies reinsured with the Reinsurer as long as the data cannot be identified
as belonging to the Ceding Company.
DURATION OF
AGREEMENT
21.1
|
This
Agreement is indefinite as to its duration. The Ceding Company or the
Reinsurer may terminate this Agreement with respect to the reinsurance of
new business by giving 90 days written notice of termination to the other
party, sent by certified mail. The first day of the notice period is
deemed to be the date the document is
postmarked.
|
During
the 90 day notification period, the Ceding Company will continue to cede and the
Reinsurer will continue to accept policies covered under the terms of this
Agreement. Reinsurance coverage on all reinsured policies will remain in force
until the termination or expiry of the policies or until the contractual
termination of reinsurance under the terms of this Agreement, which ever occurs
first. All provisions of this Agreement will survive its termination to the
extent necessary to carry out the purpose of this Agreement.
EXECUTION
22.1
|
This
Agreement is effective as of April 14, 2008, and applies to all eligible
policies with issue dates on or after such date, not withstanding that
such policies 1-nay have been backdated for up to six (6) months to save
age. This Agreement has been made in duplicate and is hereby executed by
both parties.
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American
National Insurance
Company Swiss
Re Life & Health America Inc.
By: By:
(signature) (signature)
(print or type
name) (print
or type name)
Title: Title:
Date: Date:
Location:
Galveston,
TX Location:
Attest: Attest:
(signature) (signature)
Title: Title:
EXHIBIT
A
Retention
Limits of the Ceding Company
A.1
(a) Life
Insurance - Maximum Limits of Retention
Issue
Age
|
Standard-Table
[16]
|
All
|
700,000
|
(b) First
Dollar Quota Share - Ceding Company's Quota Share Percentage
The
Ceding Company will retain 25.0% of each policy up to the above maximum dollar
retention limits.
A.2 WAIVER OF PREMIUM DISABILITY
BENEFITS
Not
Reinsured.
EXHIBIT
B
Plans
Covered and Binding Limits
The
business automatically reinsured under this Agreement is defined as
follows.
B.1 PLANS,
RIDERS AND BENEFITS
Policies
issued on plans with effective dates within the applicable period shown below
may qualify for automatic reinsurance under the terms of this
Agreement.
Plan
Identification Policy
Form Commencement
Date
Executive UL bands 3 and
4 EXEC-UL,
EXEC-ULU April
14,2008
Executive UL band 2 - facultative
only EXEC-UL,
EXEC-ULU April
14,2008
Executive UL band I - to avoid
overretention EXEC-UL,
EXEC-ULUApril
14,2008
B.2 BASIS
The
Reinsurer's share will be 33.333334% of the total ceded amount on each policy on
a first dollar quota share basis. This amount will not exceed the Reinsurer's
share of the maximum Automatic Binding Limits specified in Exhibit
B.3.
B.3 AUTOMATIC
BINDING LIMITS
(a)
Life
Issue
Ages
|
(Pool)
Maximum
Standard
-Table 16
|
All
|
$20,000,000
|
The
(pool) maximum autobind amounts above exclude the Ceding Company's
retention
(b)
Waiver of Premium Disability Benefits: Not Reinsured
B.4 JUMBO
LIMITS
The
Ceding Company will not cede any risk automatically if, according to information
available to the Ceding Company, the total amount in force and applied for on
the life with all insurance companies, including any amount to be replaced,
exceeds the applicable amounts shown below.
(a) Life:
$50,000,000
(b) Waiver
of Premium Disability Benefits: Not Reinsured.
B.5 CONDITIONAL
RECEIPT OR TEMPORARY INSURANCE AGREEMENT
The
amount of coverage provided by the Reinsurer under a Conditional Receipt (or
Interim Receipt) will not exceed the lesser of:
1. The
Reinsurer's share of $500,000; or
2. The
Automatic Acceptance Limits: or
3.
|
The
Reinsurer's share of the difference between the amount of insurance
provided by the Conditional Receipt (or Interim Receipt) and the Ceding
Company's maximum retention assuming the life had been underwritten as
standard.
|
|
The
Ceding Company's retention will include any amounts retained under any in
force policies on the life.
|
B.6 CESSION
LIMITS
(a) Minimum
Initial Cession: Total amount ceded to all reinsurers on an automatic basis must
equal or exceed $75,000
(b) Trivial
Amount Total amount ceded to all reinsurers must exceed $25,000
EXHIBIT
C
Forms,
Manuals and Issue Rules
The
Ceding Company affirms that the following have been supplied to the Reinsurer
and are in use as of the effective date of this Agreement:
1
|
Policy
Application Form(s)
|
|
9927
Rev. 3-01
|
2.
|
Underwriting
Requirements Grid (medical and
non-medical)
|
|
Form
4832 Rev. 07/04
|
3.
|
Underwriting
Guidelines/Rules
|
|
American
National Guidelines.pdf 2/16/05
|
4.
|
Preferred
Underwriting Criteria or Rules
|
|
Form
4832 Rev. 07/04. Proposed preferred criteria February
2006.xls
|
5.
|
Policy
Form(s)
|
|
Cash
Accumulation UL Specs 8-20-07.doc,
EXEC-UL
|
|
6.
|
Supplemental
Benefit and Rider Form(s)
|
7.
|
Premium
Rates
|
|
VBT2001ALB.xls
|
The
Ceding Company affirms that the following Underwriting Manual is in use as of
the effective date of this Agreement:
Swiss Re
Manual
EXHIBIT
D
Allocation
Rules for Placement of
Facultative
Cases
Does not
apply.
EXHIBIT
E
Reinsurance
Premiums
E.1 LIFE
Plans
covered under this Agreement will I be reinsured on a YRT basis. Reinsurance
premiums will be based on the 2001 VBT Smoker/Non-Smoker Distinct Select &
Ultimate (Male & Female) ALB rate scale shown in Exhibit 1, times the
following multiples in all years:
Plans
|
Issue
age
|
Band
3*
|
Band
4
|
||||||
0-39
|
40-69
|
00-00
|
00-00
|
00-00
|
00-00
|
00-00
|
00-00
|
||
Life
Coverage
|
Preferred
Plus
Nonsmoker
|
55%
|
47%
|
58%
|
66%
|
53%
|
45%
|
56%
|
62%
|
Preferred
Nonsmoker
|
62%
|
53%
|
63%
|
70%
|
60%
|
51%
|
60%
|
67%
|
|
Standard
Plus Nonsmoker
|
67%
|
59%
|
70%
|
80%
|
64%
|
57%
|
67%
|
77%
|
|
Standard
Nonsmoker
|
82%
|
71%
|
76%
|
85%
|
79%
|
68%
|
73%
|
82%
|
|
Preferred
Smoker
|
68%
|
70%
|
83%
|
92%
|
65%
|
67%
|
80%
|
88%
|
|
Standard
Smoker
|
92%
|
92%
|
93%
|
105%
|
88%
|
88%
|
89%
|
101%
|
Bands
1&2: $100.000 - $499,999
Band 3:
$500,000 - S999,999
Band 4:
$1,000,000 +
*Band 3
rates will also apply to any Band I or 2 policies reinsured as a result of the
Ceding Company having previously reached maximum retention on a
life.
E.2 AGE
BASIS
Age Last
Birthday
E.3 POLICY
FEES
The
Reinsurer will not participate in any policy fees.
E.4 RECAPTURE
PERIOD
Number of
years: 20
E.5 STANDARD
RATINGS
Premiums
will be based on the standard rate increased by an extra 25% per table of
assessed rating.
Discounts
are the same as those for standard life coverage.
E.6 EXTRAS
The total
premium remitted to the Reinsurer will include the flat extra premium minus the
discounts shown below.
Type of
Flat Extra
Premium First
Year Renewal
Temporary
(1-5
years) 10% 10%
Permanent
(6 years &
greater) 75% 10%
E.7 RIDERS
AND BENEFITS
None
Reinsured.
E.8 Interest Calculation on Late
Payments:
Any
amounts remaining unpaid for more than 30 days from the due date as specified in
Exhibit G or otherwise required will accrue interest from the due date at a rate
equal to the Three Month London Interbank Offering Rate (LIBOR) as published in
the Wall Street Journal (or if not available, a comparable publication) on the
due date or, if the due date is not a business day, on the next business day
after the due date, plus 50 basis points per annum to be compounded and adjusted
every three months after such due date.
E.9 CONDITIONS REQUIRING CLAIMS
CONSULTATION:
Before
conceding liability or making settlement to the claimant, the Ceding Company
will seek the Reinsurer's recommendation if:
|
a)
|
The
claim occurs during the contestable period and the Ceding Company is not
contesting the claim, but the Reinsurer's share exceeds $0,
or
|
|
b)
|
The
claim occurs outside of the United States or Canada, and the Reinsurer's
share exceeds $0, or
|
|
c)
|
The
claim is one for which there is no body, i.e. the insured is missing and
presumed dead, and the Reinsurer's share exceeds
$0.
|
If the
Reinsurer discovers that the Ceding Company's claims paying practices and
procedures differ materially from those performed at the inception of the
Agreement or from the Business Guidelines, then, in addition to any other
remedies, the Reinsurer may, with 30 days' written notice, adjust the threshold
amounts specified above.
EXHIBIT
F
Conversion
Premiums
Premium
rates for conversions to plans not covered by an existing agreement with the
Reinsurer shall be the same as the rates defined in Exhibit E of this
agreement.
EXHIBIT
G
Self-Administered
Reporting
G.
1
The
Ceding Company will self-administer all reinsurance reporting. The Ceding
Company will send the Reinsurer the reports listed below at the frequency
specified. The Ceding Company acknowledges that timely and correct compliance
with the reporting requirements of this Agreement are a material element of the
Ceding Company's responsibilities hereunder and an important basis of the
Reinsurer's ability to reinsure the risks hereunder. Consistent and material
non-compliance with reporting requirements, including extended delays, will
constitute a material breach of the terms of this Agreement.
Transaction
Reports: Monthly
1. New
Business
2. First
Year - Other than New Business
3. Renewal
Year
4. Changes
and Terminations
5. Accounting
Information
Periodic
Reports Annually
6. Statutory
Reserve Information
7. Policy
Exhibit Information
8. Inforce
A brief
description of the data requirements follows below.
Transaction
Reports
The
Ceding Company agrees to report policy data using the TAI system. The Ceding
Company will inform the Reinsurer at least one reporting period in advance of
any change in the reporting format or data prior to its use in reports to the
Reinsurer. The Ceding Company will provide the Reinsurer with a test file
containing such a change prior to its implementation in the production of
reports.
1. New
Business
This
report will include new issues only, the first time the policy is reported to
the Reinsurer. Automatic and Facultative business will be identified
separately.
2. First
Year -Other than New Business
This
report will include policies previously reported on the new business detail and
still in their first duration, or policies involved in first year premium
adjustments.
3. Renewal
Year
All
policies with renewal dates within the Accounting Period will be
listed.
4. Changes
and Terminations
Policies
affected by a change during the Current reporting period will be included in
this report. Type of change or termination activity must be clearly identified
for each policy.
The
Ceding Company will identify the following transactions either by separate
listing or unique transaction codes: Terminations, Reinstatements, Changes,
Conversions, and Replacements. For Conversions and Replacements, the Ceding
Company will report the original policy date, as well as the current policy
date.
5. Accounting
Information
Premiums
and allowances will be summarized for Life coverages, Benefits, and Riders by
the following categories: Automatic and Facultative, First Year and
Renewals.
Periodic
Reports
6. Statutory
Reserve Information
Statutory
reserves will be summarized for Life covet-ages, Benefits and Riders. The Ceding
Company will specify the reserve basis used.
7. Policy
Exhibit Information
This is a
summary of transactions during the current period and on a year-to-date basis,
reporting the number of policies and reinsured amount.
8. Inforce
This is a
detailed report of each policy in force.
Minimum
Data Requirements for Electronic Administration:
Policy
record details for new business, renewal business and changes and terminations
(Reports #1, 2 3 and 4 in Transaction Reports, above) may be reported as
separate reports or combined into one report, hereinafter referred to as the
Xxxxxxxx and Transactions Report. Nonetheless, the data elements specified below
for the Xxxxxxxx and Transactions Report must be provided for each reported
record.
Xxxxxxxx
and Transactions Report:
General
|
|
1.
Reporting Period Dates
|
Specifies
the beginning and ending date of the reporting period represented on the
statement file.
|
Insured
Data
|
|
2.
Last Name
|
Represents
the surname or family name of the insured; must be specified for each
insured on joint policy types; name fields are required to be parsed out
into these listed components
|
3.
First Name
|
Represents
the given name of the insured; must be specified for each insured on joint
policy types; name fields are required to be parsed out into these listed
components.
|
4.
Middle Name or Middle Initial (if available)
|
Represents
the middle name of the insured; must be specified for each insured on
joint policy types; name fields are required to be parsed out into these
listed components.
|
5.
Date of Birth
|
Specifies
the date on which the insured was born; this field must be provided on
each insured on a joint policy.
|
6.
Sex
|
Indicates
the gender of the insured; this field must be provided on each insured on
a joint policy.
|
7.
Tobacco Use Code
|
Indicates
whether the insured is a smoker or user of tobacco
products.
|
8.
Rating
|
Indicates
whether the insured is standard, substandard, or
uninsurable.
|
9.
Residence
|
State,
province, or other geographical code that indicates where the insured
resides.
|
10.
Insured Sequence Number
|
Specifies
the number assigned by the ceding company to delineate one insured from
another on a policy with multiple insureds.
|
Coverage
Data
|
|
11.
Currency
|
Indicates
the currency to be applied in calculating monetary amounts, if currency
within this treaty is a variable on a by policy basis.
|
12.
Reinsurance Method
|
Indicates
whether the policy is being ceded on an automatic or facultative
basis.
|
13.
Policy Number
|
Specifies
the number assigned by the ceding company to the policy
record.
|
14.
Coverage Sequence Number
|
Specifies
the number assigned by the ceding company to delineate one coverage or
benefit from another on a policy with multiple coverages or
benefits.
|
15.
Issue Date
|
The
date the policy or benefit was issued.
|
16.
Reinsurance Effective Date (if different than issue date)
|
Specifies
the date upon which the reinsurance coverage goes into effect, if it goes
into effect on a date other than the issue date. Can also be used to
specify the original Policy Issue Date on a contractual policy
conversion.
|
17.
Plan Code
|
Specifies
the plan of insurance being provided to the insured; there must be a
separate plan code for each coverage.
|
18.
Joint Life Indicator
|
Indicates
that the coverage is a joint coverage and that multiple lives are involved
with the coverage.
|
19.
Smoker Code
|
Indicates
that the coverage has been issued at either non-smoker or smoker
rates.
|
20.
Preferred Risk Class
|
Indicates
the level of classification between the preferred and standard categories;
there may be more than one level of the preferred classification
available, and this will indicate the specific level for this
policy.
|
21.
Mortality Rating
|
Specifies
the exact rating assigned to the policy; premium rates will be based on
this rating; this rating is generally expressed as a
percentage.
|
22.
Flat Extra Rate
|
Specifies
a flat rate per thousand to be charged on the
policy.
|
EXHIBIT
H
Application
for Facultative Reinsurance
Submitted
to: [Reinsurer
11] [Reinsurer
2]
[Reinsurer
3] [Reinsurer
4]
From:
[Ceding
Company] Date:
[Enter Date]
Policy
Number: [Enter Policy
Number] Increasing
Amount: q Yes
q
No
Plan
Name: [Enter Plan
Name] If
increasing, ultimate amount: [Enter Amount]
Last
Name
|
First
|
Middle
|
Birth
date M/D/Y
|
Sex
|
Tobacco
Use
|
Pref
Class
|
[Enter
Name]
|
[Enter
Name]
|
[Enter]
|
[MM/DD/YY]
|
[M/F]
|
[Y/N]
|
[Enter]
|
Joint
Insured
|
||||||
[Enter
Name]
|
[Enter
Name]
|
[Enter]
|
[MM/DD/YY]
|
[M/F]
|
[Y/N]
|
[Enter]
|
Life
|
Specify
others. e.g. Second
Life,
Waiver', ADB, etc.
|
||
Previous
inforce with co.:
|
[Enter]
|
[Enter]
|
[Enter]
|
Of
which we retain:
|
[Enter]
|
[Enter]
|
[Enter]
|
Now
applying for:
|
[Enter]
|
[Enter]
|
[Enter]
|
Of
which we will retain:
|
[Enter]
|
[Enter]
|
[Enter]
|
Reins.
Amount Applied for:
|
[Enter]
|
[Enter]
|
[Enter]
|
In excess
of
Jumbo: q Yes q No If Replacement: q Internal q
External
Our
Mortality Assessment:
[Enter] Special
Risk Features:
(table
&/or flat
extra) q
Aviation
q
Foreign/Travel
q
Occupation/Avocation
Enclosed Requirements:
[Enter]
Requirements to follow:
[Enter]
Remarks:
[Enter Remarks]
Underwriting
Contact:
[Enter] Tel
#: [Enter]
e-mail: [Enter]