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Forms - Insurance Intermediaries

Licence Application Forms

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A1 Individual Licence Application (Individual Insurance Agent/TR(A)/TR(B))

Applicants are required to submit licence application via Insurance Intermediaries Connect (“IIC”).

Important Notes:
  1. Please read "Notes on Application for Insurance Intermediary Licence" before completing Form A1.
  2. Before submission, please also check the Register of Licensed Insurance Intermediaries to ensure the applicant is not holding an active licence with the Insurance Authority.
  3. If the applicant is holding an active licence and he/she/it is not going to change his/her/its licence type under a new appointment, then a Form N2 should be used to notify the IA of the new appointment instead of Form A1.  Please note that a new appointment of an active licensee is NOT a new application.
 IIC Updatedpdf
A2 Online Portal – Application for Opening of Supervisor Account 

Authorized insurers, licensed insurance agencies and licensed insurance broker companies are required to submit an originally signed Form A2 to apply for opening of a Supervisor Account of Insurance Intermediaries Connect for e-submission of applications for individual licence. For more information about the Insurance Intermediaries Connect, please refer to the following user guides:
  • User Guide of the Insurance Intermediaries Connect for Individual Applicants to Submit an Individual Licence Application
  • User Guide of the Insurance Intermediaries Connect for Principals
  • Demonstration Video - Opening of Supervisor Account of the Insurance Intermediaries Connect
  • Demonstration Video – Activation of Individual Account 
  • Demonstration Video – Completion and Submission of Application Form
  • Demonstration Video – Amendment to Application Form
  • Introduction Video - Licensing and Related Fees
  • IIC Leaflet
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A3 Application for Proposed Appointment of a Responsible Officer

Existing agency and broker company applicants are required to download and submit a duly-filled application form via Insurance Intermediaries Connect. Application being made as part of a new licence application for an insurance agency or insurance broker company, should be submitted by paper application.		 Updatedpdf
A4 Application for Insurance Broker Company Licence

Please submit an application in paper form. Please provide the Insurance Authority with the documents specified in the following checklist when submitting the insurance broker company licence application.
  • Checklist of Documents for Insurance Broker Company Licence Application
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A5 Application for Insurance Agency Licence

Please submit an application in paper form. Please provide the Insurance Authority with the documents specified in the following checklist when submitting the insurance agency licence application.
  • Checklist of Documents for Insurance Agency Licence Application
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A6 Application for Approval of the Varying Line(s) of Business by Individual Insurance Agent/TR(A)/TR(B)

Applicants are required to submit licence application via Insurance Intermediaries Connect.
Application for Approval of the Varying Line(s) of Business by Insurance Agency and Insurance Broker Company

Please submit an application letter in paper for approval of the varying line of business.		 IIC


Licence Renewal Form

Form Form Details View
R1
Application for Renewal of Licence (Individual Insurance Agent/TR(A)/TR(B))

Licensees are required to submit licence renewal application via Insurance Intermediaries Connect.

Important Notes:
  • Under Section 64ZV of the IO, renewal application of a licensed insurance intermediary may only be made no later than 45 days before the licence is due to expire.  Otherwise, IA will not be able to guarantee that such application will be processed before the expiry date.
Online Portal - Insurance Intermediaries Connect

Licensed individual insurance agents, licensed technical representatives (agent) and licensed technical representatives (broker) are required to activate an Individual Account of Insurance Intermediaries Connect for e-submission of applications for renewal of licence. For more information about the Insurance Intermediaries Connect, please refer to the following user guides:
  • User Guide of the Insurance Intermediaries Connect for Individuals - Licence Renewal Application
  • User Guide of the Insurance Intermediaries Connect for Principals - Licence Renewal Application
 IICUpdatedpdfUpdatedpdf
R4 Application for Renewal of Licence (Insurance Broker Company)

Licensees are required to submit licence renewal application via Insurance Intermediaries Connect.

Important Notes:
  • Under Section 64ZV of the IO, renewal application of a licensed insurance intermediary may only be made no later than 45 days before the licence is due to expire. Otherwise, IA will not be able to guarantee that such application will be processed before the expiry date.
 IIC
R5 Application for Renewal of Licence (Insurance Agency)

Licensees are required to submit licence renewal application via Insurance Intermediaries Connect.

Important Notes:
  • Under Section 64ZV of the IO, renewal application of a licensed insurance intermediary may only be made no later than 45 days before the licence is due to expire. Otherwise, IA will not be able to guarantee that such application will be processed before the expiry date.
 IIC


Notification Forms

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N1 Notification of Termination of Appointment

Principals are required to submit the notification via Insurance Intermediaries Connect.

Under section 64R of the IO, within 14 days after the day on which an authorized insurer, a licensed insurance agency or a licensed insurance broker company (collectively, “Appointing Principal”) terminates the appointment of a licensed insurance agency, a licensed individual insurance agent, a licensed technical representative (agent), a licensed technical representative (broker) or a responsible officer (as the case may be), the Appointing Principal should notify the IA in submitting of the termination.		 IIC
N2 Notification of Appointment

Principals are required to submit the notification via Insurance Intermediaries Connect.

Under section 64Q of the IO, at least 14 days before an authorized insurer, a licensed insurance agency, or a licensed insurance broker company (collectively, “Appointing Principal”) appoints a licensed insurance agency, a licensed individual insurance agent, a licensed technical representative (agent), a licensed technical representative (broker) (as the case may be), to carry on regulated activities in one or more lines of business as an agent of the Appointing Principal, the Appointing Principal should notify the IA in writing of the intended appointment.		 IIC
N3 Notification of Change in Particulars (Individual Insurance Agent/TR(A)/TR(B)) 

Under section 64P of the IO, a licensed insurance intermediary must notify the IA of any change of particulars (i.e. name, business or residential business, telephone number or email address) within 14 days after the date on which the change takes

Important Notes:
The IA only accepts paper notification of change in mobile number or email address to retrieve Insurance Intermediaries Connect login details. Other than that, licensees are required to submit notification via Insurance Intermediaries Connect.		 Updatedpdf
N4 Notification of Change in Particulars (Insurance Agency/Insurance Broker Company) 

Licensees are required to submit the notification via Insurance Intermediaries Connect.

Under section 64P of the IO, a licensed insurance intermediary must notify the IA of any change of particulars (i.e. name, business address, telephone number or email address) within 14 days after the date on which the change takes place.

For change of name and business address, please also submit the new business registration certificate and the notification forms filed with the Companies Registry as the supporting documents.		 IIC
N5 Notification of Change in Partners, Directors or Controllers of a Licensed Insurance Agency or Licensed Insurance Broker Company

Under section 64ZZD of the Insurance Ordinance, a licensed insurance intermediary must notify the IA in writing of any change in partners, directors or controllers within 1 month after the date on which the change takes place.		 pdf

Supplemental Forms

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S1 Supplemental Form – Information on Other Licence(s)  pdf
S2 Supplemental Form – Information on Bankruptcy, Liquidation or Similar Proceedings pdf
S3 Supplemental Form – Information on Criminal Record  pdf
S4 Supplemental Form – Information on Disciplinary Action Record  pdf
S5 Supplemental Form – Information on Director/Controller (Individual) Updatedpdf
S6 Supplemental Form – Information on Director/Controller (Body Corporate)  Updatedpdf

Other Forms

Form Form Details View
-- Continuing Professional Development (CPD) Declaration Form

for the CPD Assessment Period of 2023 - 2024		 pdf
O1 Request for Licence Revocation by Licensed Insurance Intermediary

Licensees are required to submit licence revocation request via Insurance Intermediaries Connect.		 IIC