chhatramani/Nepal-Legal-Text-Corpus-44laws huggingface dataset:
Insurance Act 2079

Chapter- 17 Provision Relating to Complaint

Section 129: Complaint Regarding Loss or Damage
1) If any insurer or its director or official or employee insurance intermediary or other insurance service provider cause to make damage or loss to any insured by performing acts against the interest of the insured, the concerned insurer shall be liable for it and shall compensate for this.
2) If damage or loss is caused by performing such an act, the insured may complain to the Authority within the prescribed period from the date of getting it to the knowledge.
3) In case the complaint is received pursuant to sub-section (2), the Authority shall make necessary investigation or verification and shall provide seven days to the concerned insurer, director, official, employee or concerned insurance intermediary to submit clarification.
4) In case the clarification as per sub-section (3) is received or not within the period provided to submit clarification, the Authority shall make an investigation and may order to compensate reasonable amount from the party who has caused to  loss to the complainant for lieu of damage or loss or may order to make a compromise between the insurer and the complainant.
5) The person being dissatisfied with the order to compensate pursuant to sub-section (4) may appeal in the concerned High Court within 35 days.
6) Other provisions relating to actions of a complaint under this section shall be as prescribed.

Insurance Act 2079

Chapter- 17 Provision Relating to Complaint

Section 130: Insurance Mediation
In case any dispute has arisen between the parties who have received license under this Act such as between the insurers or between the insurance intermediaries or between the insurer,
intermediary or the parties of insurance, and if there is a failure to solve the dispute on mutual understanding, the Authority may mediate on the request of any one party of the dispute or on the Authority’s own initiation.

Insurance Act 2079

Chapter- 18 Operation and Management of Insurance in Province

Section 131: Operation and Management of Insurance in Province
1) Provinces may, subject to this Act, operate and manage insurance by formulating laws on the following subject:
a) To make access to the  insurance,
b) To issue and renew the license of an insurance agent as prescribed,
c) To operate training programmes related to insurance,
d) To receive a hearing of complaint on prescribed subjects.
2) While performing the work pursuant to sub-section (1), the work shall be performed pursuant to the standards prescribed by the Authority.
3) Notwithstanding anything contained elsewhere in this Act, the Authority shall perform the activities as per this Section until the commencement of own activities by the province formulating the laws.
Insurance Act 2079

Chapter- 18 Operation and Management of Insurance in Province

Section 132: Details to be Provided
1) The Authority shall provide the information of insurers and insurance intermediaries having licenses received under this Act to the province’s concerned body.
2) The insurer shall provide the information of the branches established in the province as well as the information of the insurance intermediaries associated with itself to the concerned body of the province.

Insurance Act 2079

Chapter- 18 Operation and Management of Insurance in Province

Section 133: Annual Report Submit
The insurer operated and managed in accordance with Section 131 by the province shall prepare an annual report as prescribed, incorporating details of the activities performed during the year in the concerned Province, and submit it to the concerned body of the province. One copy of the report shall also be submitted to the Authority.
Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 135: Authority May Give Direction to Withold Payment of Insurance or Revoke the Insurance  Policy
Notwithstanding anything contained in this Act, the Authority may give direction not to issue insurance policy to anyone or withhold the payment of an amount to be paid as  per the insurance policy or revoke (cancel) the insurance policy in the following circumstances:
(a) To prevent from being any action against the interest of the insurance business or the insured,
(b) To assist in the investigation of any offence,
(c) To assist in controlling the offence of money laundering and financial investment in activities pertaining to terrorism, fraud, corruption, human trafficking or other organised crime.

Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 136: Suspension of License or Ban of Insurance Business
1) The Authority may suspend the license of an Insurer for a certain period or impose a full or partial ban to perform the insurance business if any insurer performs any of the following acts:
(a) In case of failure to maintain the minimum paid-up capital pursuant to Section 36,
(b) In case the decision regarding the loss, damage or payment of claim pursuant to the provisions of Section 128 or 129 is not implemented within the specified time,
(c) In case it is deemed to cause serious detriment (loss) to the insured if allowed the insurer to operate the insurance business,
(d) Closing the insurance business without the approval of the Authority,
(e) Performing any other acts prohibited by this Act or Rules, By-laws framed under this Act or the existing laws,
(f) Frequent violations of the directions or order provided by the Authority.
2) The Authority shall provide a reasonable opportunity to the insurer to submit clarification before suspending the license or imposing a full or partial ban pursuant to sub-section (1).
3) The Authority may release the suspension or ban if the clarification submitted by the insurer pursuant to sub-section (2) seems to be satisfactory.
4) In case the insurer is banned from performing the insurance business fully or partially, the information shall be published in at least two national-level daily newspapers and through the Authority’s website for the general public pursuant to sub-section (1).
Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 137: Revocation (Cancellation) of License of the Insurer
1) The Authority may revoke the license of the insurer in the following conditions:
(a) Being failure to release the ban to perform the insurance business or the suspension of the license pursuant to Section 136 up to one year,
(b) In case it is deemed to cause serious detriment (loss) to the insured if allowed the insurer to operate the insurance business,
(c) In case the insolvency proceedings are commenced by the court as per the prevailing laws against the insurer,
(d) In case an application is submitted by the insurer for the dissolution and the process of dissolution is completed.
2) The Authority shall provide reasonable opportunity by allowing an appropriate period, as prescribed to the insurer, for submitting clarification before revoking the license of the insurer except the conditions of clauses (c) or (d) of sub-section (1).
3) Notwithstanding anything contained in this section, in case the condition as mentioned in clauses (a) or (b) of Sub-section (1) is created and the insurer has committed to improve the condition and not to repeat the weaknesses, the Authority may provide a reasonable period for once to the concerned insurer to improve its condition or for correcting weaknesses.
4) In case the license of any insurer is revoked pursuant to this Section, the liabilities taken by the insurer before revocation of the license shall be settled as prescribed.
5) In case the license is revoked as per this Section, the Authority shall publish the name of the concerned insurer in at least two national-level daily newspapers and through the Authority’s website for the information of the general public.
Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 139: Procedures of Taking Actions
1) The Authority shall give written notice to the concerned insurer, insurance intermediary or other insurance service provider or person providing a time limit of 7 days to submit clarification in reference to the proposed proceedings and the fine before taking regulatory action pursuant to Section 134 or imposing fine pursuant to Section 138.
2) The concerned insurer, insurance intermediary or any person shall have to submit their clarification in writing to the Authority within seven days from the date of written notice received in accordance with sub-section (1).
3) If the clarification submitted seems reasonable pursuant to sub-section (2), the Authority may amend the action or fine or repeal (cancel) the same.
4) Other procedures to be adopted by the Authority under this Act while taking action or imposing the fine shall be as determined by the Authority.
Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 140: Offence
1) The following acts shall be deemed as offences committed under this Act:
(a) In case an Insurance business being operated without obtaining a license pursuant to Section 24,
(b) In case performing works as an insurance intermediary or other insurance service provider without obtaining a license pursuant to Section 90,
(c) In case an insurance claim is being paid by the insurer by committing fraudulent acts or preparing or not preparing fake statements or documents aligning or not aligning with an insurance intermediary or other insurance service provider or other parties,
(d) If an insurance claim was received by the insured by committing fraudulent acts or submitting or not submitting fake statements or documents aligning or not aligning with an insurance intermediary or other insurance service provider or other parties,
(e) In case of evaluating the loss, if any insurance surveyor performs an overestimate, underestimate or wrong evaluation selfishly or maliciously, causing the insurer or the insured to suffer loss or damage,
(f) If any insurance agent did not hand over the insurance premium payable by the insured to the insurer according to the insurance policy and misappropriated the amount,
(g) In case the employee, official or any person of the insurer commits any irregularities of financial misappropriation while issuing the insurance policy, assessing the loss of insured assets and liabilities, making payment of insurance claims or during the course of operation of insurance business,
(h) If any director, official, chief executive, employee or other person commits irregularities during the course of merger or amalgamation, acquisition, dissolution or auditing of insurance,
(i) If anyone attempted to commit offence from clause (a) to (h) or assisted to commit such offences in any way.
2) If any official or employee of foreign insurer, except in the course of regular transactions  of the branch office, transfers any property of the branch office to another country without obtaining
the approval from the Authority or obtain the approval by submitting fake statements, provide authority or power to do so or perform any act to assist or make to assist that work which shall
be deemed as an offence committed pursuant to this Act.
Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 141: Punishment
1) If any person commits an offence pursuant to Section 140 (1) (a), the involved property instead of the claimed amount shall be seized and be imposed with a penalty equivalent to three times the claimed amount, and the person operating that business shall be imprisoned for five to ten years.
2) If any person commits an offence pursuant to Section 140 (1) (b) (c) (d), the property involved instead of the claim amount shall be confiscated and imposed with a penalty equivalent to the property involved instead of the claimed amount or will be imprisoned for three to ten years.
3) If any person commits an offence pursuant to Section 140 (1) (e ) (f) (g) (h), the properties involved instead of the claimed amount shall be confiscated, and the offender is liable to have punishment as follows :
(a) Imprisonment for up to one year if the amount is up to one million rupees,
(b) Imprisonment for up to two years if the amount is more than one million rupees and up to five million rupees,
(c) Imprisonment for up to three years if the amount is more than five million rupees and up to one crore rupees,
(d) Imprisonment for up to three to five years if the amount is more than ten million rupees, whichever is greater.
4) If any person commits an offence pursuant to section 140 (1) (i), Half of the punishment is to be imposed on the principal offender.
5) If any person commits an offence pursuant to section 140 (2), a fine equivalent to the claimed amount and imprisonment up to 5 years.
6) While determining the amount of claim for the purpose of this Section, the claimed amount shall be determined by calculating the amounts of all transactions.
7) In case of failing to determine the claimed amount under this Section, a fine up to Rs. 1 million and imprisonment up to 2 years shall be imposed, depending upon the extent of the offence.
8) If any work liable to punishment under this Section is performed by any corporate body, the concerned director, chief executive, official or employee who commits such act involving the offence shall be punished.

Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 142: Don’t work in the Insurance Business
In case director, official or employee or the license of any insurance agent, insurance, a or intermediary of the insurer has been suspended, or a case related with offence pursuant to a  Section 140 has been filed in the court against them, such director, official, chief executive, consultant or employee or insurance intermediary shall not be allowed to perform any work related with insurance business until such suspension is released or final decision of the case is made.
Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 143: Special Provision Related with The Insured
1) If any insured has committed fraud, forgery acts relating to the insurance aligning or not aligning with the insurer or insurance intermediary or other insurance service provider or submitted or not submitted fake statements, not submitted the statements which to be submitted or submitted the statements which need not be submitted, concealed the fundamental facts about own self or insured properties, if there is doubt about making claim of any insurance or doubt of influencing the insurer or insurance intermediary or other insurance service provider, the Authority may inspect or verify upon such insured.
2) It shall be the duty of the insured to assist the Authority while performing the acts of inspection or verification in accordance with sub-section (1).
3) In accordance with sub-section (1), if the Insured is found guilty from inspection or verification, it shall be sent in writing to the authorised body pursuant to the prevailing laws.
4) The Authority may, upon written notice from an authorized body under the prevailing law, blacklist any insured or any other person who does not cooperate in the investigation or inquiry pursuant to this Section, commits insurance fraud or insurance fraud and prohibit such person from insuring any business in which such person is involved for a period of five years.
5) Other provisions relating to the investigation or inquiry of the insured shall be as prescribed.

Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 144: Punishment for those who oppose obstacles
If anyone obstructs and opposes the activities related to investigation or verification under this Act, the adjudicating official may, on the basis of the report of the official appointed for investigation or verification, impose a punishment of imprisonment up to six months or a fine not exceeding one hundred thousand rupees or both.

Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 145: Limitation for Complaint
If it comes to the knowledge of the Authority through any channel or from inspection of the Authority and inspection or verification made by authorised officials or bodies pursuant to the prevailing laws about committing of such act which is deemed as offence under this Act or if it is proved that such act is committed, the complaint may be submitted within six months from the date of it being proved and lawsuit, shall be filed in the court within three months from the date of complaint made.

Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 146: Government of Nepal to be Plaintiff
1) The case concerning the offences pursuant to Section 140 shall be prosecuted as the Government of Nepal is the plaintiff, and such cases shall be deemed to be included in Schedule-1 of Criminal Code Procedure, 2074.
2) The Authority shall provide necessary assistance to the concerned official in the process of investigation, collection of evidence and filing of the case in accordance with sub-section (1).
Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 147: Authority to Hear Case and Execution of The Decision
1) The authority to proceed and finalise the case concerning offences under Section 140 shall be vested on the court as prescribed by the Government of Nepal publishing a notice in Nepal Gazette.
2) The Authority itself may take action and give punishment to other works prohibited under this Act, other than mentioned in sub-section (1), after having investigation or verification.
3) For the purposes mentioned in sub-section (2), the Authority shall have the authority as equal to the authority of the District Court in addition to the powers provided in the rules framed under this Act for the purpose of investigation or in the court as prescribed by the verification and imposing punishment.
4) The hearing on the appeal or application submitted in the High Court, as per this Act, shall be made by the commercial bench of the concerned High Court.

Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 148: Request for Details
1) In the course of an investigation or inquiry to be conducted in relation to regulation or action under this Act, if the Authority or the investigating or investigating body considers it necessary to conduct an investigation or inquiry to obtain any document, account statement, document or other particulars and if it considers that any person or organisation has such document, account statement or other particulars or that such person or organisation can produce such particulars, the Authority or the investigating or investigating body may request such person or organisation to produce such particulars.
2) It shall be the duty of all persons or organisations concerned to provide or assist in providing any document, account statement or other particulars requested by the investigating or investigating body pursuant to sub-section (1).

Insurance Act 2079

Chapter- 19 Actions, Offences and Punishment

Section 149: No Obstruction for Punishment
If it is found that any person committed any kind of offence pursuant to Section 138 while being incumbent in any post of the insurer, it shall not be obstructed for investigation or verification or impose punishment due to the reason of being retired from that post or not taking the responsibility of that post at present.

Insurance Act 2079

Chapter- 20 Miscellaneous

Section 150: Insured Insurance Protections Fund
1) There shall be one Insured Interest Protection Fund formed under the Authority.
2) The following amounts shall be credited to the Fund:
(a) The amount earmarked by the Authority for this purpose,
(b) The amount received from the insurer operating life insurance business as prescribed by the Authority,
(c) The amount deposited in unclaimed fund as per Section 125 which was to be paid under life insurance policy but could not be paid for any reason.
3) Other provisions concerning following the fund shall be as prescribed.
Insurance Act 2079

Chapter- 20 Miscellaneous

Section 151: Insurance Development Fund
1) There shall be one Insurance Development Fund in the Authority to protect the interest of the citizens through insurance, extending access to insurance to economically deprived citizens.
2) The following amounts shall be credited in the Fund:
(a)The amount received from the Government of Nepal,
(b) The amount equivalent to fifty percent of micro-insurance regulation fees to be received by the Authority from the insurer pursuant to Section 79 and at least thirty-three percent of regulation fees to be received by the Authority from the insurer pursuant to Section 100,
(c) The amount received from other sources.
3) The Authority shall deposit the amount under clause (b) in the Insurance Development Fund every year.
4) The utilisation of the amount of the Insurance Development Fund shall be made in defined area as prescribed
5) Other provisions concerning with the operation and management of Fund shall be as prescribed.

Insurance Act 2079

Chapter- 20 Miscellaneous

Section 152: Complaint Hearing
1) If anyone does have a complaint related to the activities performed by the insurer, insured or insurance intermediary or director, official, employee or insurance intermediary of the insurer or
any other concerned person pursuant to this Act, the complaint may be submitted to the Authority.
2) Other provisions regarding the hearing of the complaint and the authority to hear the complaint shall be as prescribed.

Insurance Act 2079

Chapter- 20 Miscellaneous

Section 153: Not to Make Insurance Transactions with Anyone Except Insurer
1) Any person or organisation shall not make any transactions related to the insurance business with anyone except the insurer possessing a license pursuant to this Act.
2) The insurance of properties situated in Nepal and liabilities to be created within Nepal shall be made only with the insurer possessing a license pursuant to this Act.

Insurance Act 2079

Chapter- 20 Miscellaneous

Section 154: Formation of Expert Groups
1) The Authority may form an expert group as prescribed to study, investigate or investigate claims related to fraud, forgery or deceit that may arise or have occurred in the insurance business and recommend necessary opinions for taking action, reform or formulating policies in that regard.
2) Other provisions regarding the expert group shall be as prescribed.

Insurance Act 2079

Chapter- 20 Miscellaneous

Section 155: Insurance Information Centre
1) The Authority may establish an Insurance Information Centre to collect and organise information on the insurance sector in an integrated manner.
2) The Authority shall regulate the Insurance Information Centre established pursuant to Sub-section (1).
3) Other provisions relating to the Insurance Information Centre shall be as prescribed.