Aditya Birla Health Insurance Co. Limited Registration No. 153 and Dated 11 July 2016 FORM NL-1-B-RA REVENUE ACCOUNT FOR THE QUARTER ENDED 31 DECEMBER 2016 (Rs.’000) S.No Particulars Schedule For The Quarter Ended 31st December 2016 Upto Quarter Ended 31st December 2016 For The Quarter Ended 31st December 2015 Upto Quarter Ended 31st December 2015 1 Premiums earned (Net) NL-4-Premium Schedule 25,050 25,050 - - 2 Profit/ Loss on sale/redemption of Investments - - - - 3 Others (to be specified) 29 29 - - 4 Interest, Dividend & Rent – Gross - - - - TOTAL (A) 25,079 25,079 - 1 Claims Incurred (Net) NL-5-Claims Schedule 26,746 26,746 - - 2 Commission NL-6-Commission Schedule 20,692 20,692 - - 3 Operating Expenses related to Insurance Business NL-7-Operating Expenses Schedule 2,25,761 3,37,209 - - 4 Premium Deficiency 24,426 24,426 - - TOTAL (B) 2,97,624 4,09,072 - Operating Profit/(Loss) from Fire/Marine/Miscellaneous Business C= (A - B) (2,72,545) (3,83,993) - - APPROPRIATIONS Transfer to Shareholders’ Account (2,72,545) (3,83,993) - - Transfer to Catastrophe Reserve - - - - Transfer to Other Reserves - - - - TOTAL (C) (2,72,545) (3,83,993) - -
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Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-1-B-RA
REVENUE ACCOUNT FOR THE QUARTER ENDED 31 DECEMBER 2016
Motor Own Damage Motor Third PartyFire Marine (Cargo) All Other Miscellaneous Grand TotalLiability insurance Personal Accident Medical InsuranceOverseas medical
InsuranceCrop Insurance
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-23 - Reinsurance Risk Concentration
(Rs in Lakhs)
Proportional Non-Proportional Facultative
1 No. of Reinsurers with rating of AAA and above - - - - -
2 No. of Reinsurers with rating AA but less than AAA - - - - -
3 No. of Reinsurers with rating A but less than AA 2 169 - - 100%
4 No. of Reinsurers with rating BBB but less than A - - - - -
5 No. of Reinsurres with rating less than BBB - - - - -
Total 2 169 - - 100%
Reinsurance Risk Concentration
Premium ceded to
reinsurers / Total
reinsurance premium
ceded (%)
No. of
reinsurers
Premium ceded to reinsurers
S.No. Reinsurance Placements
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-24 - Ageing of Claims
(Rs in Lakhs)
1 month 1 - 3 months 3 - 6 months 6 months - 1 year > 1 year
1 Fire - - - - - - -
2 Marine Cargo - - - - - - -
3 Marine Hull - - - - - - -
4 Engineering - - - - - - -
5 Motor OD - - - - - - -
6 Motor TP - - - - - - -
7 Health 34 - - - - 34 9.57
8 Overseas Travel - - - - - - -
9 Personal Accident - - - - - - -
10 Liability - - - - - - -
11 Crop - - - - - - -
12 Miscellaneous - - - - - - -
Ageing of Claims
S.No.No. of claims paid Total No. of
claims paid
Total amount
of claims paidLine of Business
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-25 - Quarterly claims data for Non-Life
No. of claims only
S. No. Claims Experience FireMarine
Cargo
Marine
Hull
Enginee
ring
Motor
OD
Motor
TPHealth
Overseas
Travel
Personal
AccidentLiability Crop Credit Miscellaneous Total
1 Claims O/S at the beginning of the period - - - - - - - - - - - - - -
2 Claims reported during the period - - - - - - 430 - - - - - - 430
3 Claims Settled during the period - - - - - - 34 - - - - - - 34
4 Claims Repudiated during the period - - - - - - 10 - - - - - - 10
5 Claims closed during the period - - - - - - - - - - - - - -
6 Claims O/S at End of the period - - - - - - 386 - - - - - - 386
Less than 3months - - - - - - 386 - - - - - - 386
3 months to 6 months - - - - - - - - - - - - - -
6months to 1 year - - - - - - - - - - - - - -
1year and above - - - - - - - - - - - - - -
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-26 - CLAIMS INFORMATION - KG Table I
Solvency for the quarter ended
Required solvency margin based on net premium and net incurred claims (Rs. in Lacs)
Gross
Premium
Net
Premium
Gross incurred
claim
Net incurred
Claim
1 Fire - - - - - - -
2 Marine Cargo - - - - - - -
3 Marine Hull - - - - - - -
4 Motor - - - - - - -
5 Engineering - - - - - - -
6 Aviation - - - - - - -
7 Laibilities - - - - - - -
8 Others - - - - - - -
9 Health 3,353 3,183 282 267 637 80 5,000
Total 3,353 3,183 282 267 637 80 5,000
RSM
ClaimsItem
No.Description RSM-1
PREMIUM
RSM-2
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-27 - Offices information for Non-Life
S. No. Number
1 No. of offices at the beginning of the year -
2 No. of branches approved during the year 9
3 Out of approvals of previous year -
4 Out of approvals of this year 9
5 No. of branches closed during the year -
6 No of branches at the end of the year -
7 No. of branches approved but not opend -
8 No. of rural branches -
9 No. of urban branches -
No. of branches opened during the
year
Office Information
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-28-STATEMENT OF ASSETS - 3B
Statement as on: 31st December 2016
Statement of Investment Assets (General Insurer, Re-insurers)
(Business within India)
Periodicity of Submission: Quarterly
(Rs in Lakhs)
S.No PARTICULARS SCH AMOUNT
1 Investments 8 23,927
2 Loans 9 -
3 Fixed Assets 10 2,507
4 Current Assets
a. Cash & Bank Balance 11 198
b. Advances & Other Assets 12 1,530
5 Current Liabilities
a. Current Liabilities 13 3,242
b. Provisions 14 1,868
c. Misc. Exp not Written Off 15 -
d. Debit Balance of P&L A/c 4,959
Application of Funds as per Balance Sheet (A) 18,093
Less: Other Assets SCH Amount
1 Loans (if any) 9 -
2 Fixed Assets (if any) 10 2,507
3 Cash & Bank Balance (if any) 11 198
4 Advances & Other Assets (if any) 12 1,530
5 Current Liabilities 13 3,242
6 Provisions 14 1,868
7 Misc. Exp not Written Off 15 -
8 Debit Balance of P&L A/c 4,959
TOTAL (B) (5,834)
'Investment Assets' As per FORM 3B (A-B) 23,927
Balance FRSM+
(a) (b) (c) d = (b+c) (e) (d + e)
1 G. Sec. Not less than 20% - 3,830 - 3,830 16% - 3,830 3,780
2 G. Sec or Other Apporved Sec. (incl. (1) above) Not less than 30% - 4,833 - 4,833 21% - 4,833 4,761
3 Investment subject to Exposure Norms -
1. 'Housing & Loans to SG for Housing and FFE, Infrastructure
InvestmentsNot less than 15% - 1,554 2,573 4,127 18% - 4,127 4,113
Allocated Travel Cost and Reimbursement 60 199 - -
Reimbursement of expenses received - (147) - -
3 Aditya Birla Nuvo Limited Aditya Birla Group Company Allotment of Equity Shares - - (671) (826)
Reimbursement of expenses - - - 123
4 Birla Sun Life Insurance Company Limited Aditya Birla Group Company Insurance expense 1 2 - -
Insurance premium (1,337) (1,337) - -
Space sharing cost 3 9 - -
Transfer of asset on transfer of employee - 9 - -
Transfer of employee benefits on transfer of employee (12) (33) - -
5 Aditya Birla Financial Shared Services Limited Aditya Birla Group Company Insurance premium (27) (27) - -
Shared Admin and Emp Cost 8 12 - -
6 Aditya Birla Wellness Private Limited Aditya Birla Group Company Cost of Services 3 3 - -
Reimbursement of expenses received (47) (47) - -
7 Aditya Birla Customer Services Limited (Formerly known as Aditya Birla Customer Services Private Limited)Aditya Birla Group Company Digital Marketing cost 17 17 - -
8 Aditya Birla Finance Ltd. Aditya Birla Group Company Shared Admin Cost (2) (2) - -
9 Aditya Birla Money Mart Ltd Aditya Birla Group Company Shared Admin Cost (3) (3) - -
10 Aditya Birla Housing Finance Ltd. Aditya Birla Group Company Shared Admin Cost (0) (0) - -
Related Party Transactions
S.No. Name of the Related PartyNature of Relationship with
the CompanyDescription of Transactions / Categories
Consideration paid / (received)*
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-32 - Products Information
List below the products and/or add-ons introduced during the period
S. No. Name of Product Co. Ref. No. IRDA Ref.no. Class of
Business* Category of product
Date of filing of
Product
Date IRDA confirmed
filing/ approval
1 Group Activ Health - IRDAI/HLT/ABHI/P-H(G)/V.I/19/2016-17 Health Insurance Class Rated Product 27-09-2016 30-09-2016
2 Group Activ Secure - IRDAI/HLT/ABHI/P-H(G)/V.I/18/2016-17 Health Insurance Class Rated Product 08-09-2016 30-09-2016
3 Activ health - IRDAI/HLT/ABHI/P-H/V.I/32/16-17 Health Insurance Class Rated Product 05-07-2016 31-10-2016
Products Information
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-33 - SOLVENCY MARGIN - KGII
Solvency for the Quarter ended 31st December 2016
Available Solvency Margin and Solvency Ratio
(Rs in Lakhs)
Item Description Notes No. Amount
(1) (2) (3) (4)
1 Available Assets in Policyholders’ Funds (adjusted value
of Assets as mentioned in Form IRDA-Assets-AA): 4,900
Deduct:
2 Liabilities (reserves as mentioned in Form HG) 3,436
3 Other Liabilities (other liabilities in respect of
Policyholders’ Fund as mentioned in Balance Sheet) 1,451
4 Excess in Policyholders’ Funds (1-2-3) 13
5 Available Assets in Shareholders’ Funds (value of
Assets as mentioned in Form IRDA-Assets-AA): 23,242
Deduct:
6 Other Liabilities (other liabilities in respect of
Shareholders’ Fund as mentioned in Balance Sheet) 3,484
7 Excess in Shareholders’ Funds (5-6) 19,758
8 Total Available Solvency Margin [ASM] (4+7) 19,771
9 Total Required Solvency Margin [RSM] 5,000
10 Solvency Ratio (Total ASM/Total RSM) 3.95
Aditya Birla Health Insurance Co. Limited
Registration No. 153 and Dated 11 July 2016
FORM NL-34 - Board of Directors & Key Person
S. No. Name of person Role/designation
1 Mr. Ajay Srinivasan Non Executive Director
2 Mr. Sushil Agarwal Non Executive Director
3 Mr. Devajyoti Bhattacharya Non Executive Director
4 Mr. Asokan Naidu Non Executive Director
5 Mr. Danie Botes Non Executive Director
6 Mr. S Ravi Independent Director
7 Ms. Sukanya Kripalu Independent Director
8 Mr. P Vijay Bhaskar Independent Director
9 Mr. C N Ram Independent Director
10 Mr. Mahendren Moodley Independent Director Appointed w.e.f. October 1, 2016
11 Mr. Mayank Bathwal CEO & Whole Time Director
S. No. Name of person Role/designation
1 Mr. Mayank Bathwal CEO & Whole Time Director
2 Ms. Shikha Bagai Chief Finance Officer
4 Ms. Anuradha Sriram Appointed Actuary
3 Mr. Rajiv Joshi Head - Legal, Risk, Compliance and Secretarial
8 Mr. Srinivasan SubramaniamHead - Operations
5 Mr. Amar Joshi Chief Distribution Officer
8 Ms. Darshana Shah Chief Marketing Officer
6 Mr. Sanjay Karnatak Head - Information Technology
7 Mr. Santanu Banerjee Head - Human Resource
Key Persons as defined in the Corporate Governance Guidelines issued by the IRDAI.
BOD and Key Person information
Details of change in the quarter ended December 31, 2016
Key Persons
Details of change in the quarter ended December 31, 2016
Book Value Market Value Book Value Market Value Book Value Market Value
A01 Central Government Bonds CGSB 2,758 3,780 17 0.61% 0.61% 2,758 3,780 17 0.61% 0.61% - - - 0.00% 0.00%
B GOVERNMENT SECURITIES / OTHER APPROVED SECURITIES
B02 State Government Bonds SGGB 1,003 981 5 0.53% 0.53% 1,003 981 5 0.53% 0.53% - - - 0.00% 0.00%
C a) HOUSING & LOANS TO STATE GOVT. FOR HOUSING AND FFE
C10 Bonds / Debentures issued by Authority constituted under any Housing / Building Scheme approved by Central / State / any Authority or Body constituted by Central / State ActHTDA 2,211 2,568 12 0.56% 0.56% 2,211 2,568 12 0.56% 0.56% - - - 0.00% 0.00%