A –Z Industrial Premises, 1st  Floor, Unit no. 165,G.K. Marg. Lower Parel Mumbai

 [email protected]


Worldwide Insurance Brokers Ltd.
B 42, Sector 63, Noida 201307

  [email protected]


6th Floor, Fortuna Tower,23A,
Netaji Subhas Road,Kolkata – 700001

(033) 30492608
[email protected]


203, 2nd Floor, Ashok Vishnu Capital,
Plot No.90, Road No.2, Banjara Hills,

  [email protected]


# 48, Vaishnavi Badri, 5th Main Road,
Jayamahal Extension, Bangalore 560046

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Read the following two documents carefully

  • Insurance Brokers Regulations 2018.(Click here)
  • Manual for online filing of Application (Click here)
  • The application to be filed online which is replica of Form A.
Sr. No. Particulars
1 Copy of Memorandum and Articles of Association- CA Certified
2 Shareholding pattern at the time of last renewal and at the time of renewal application- CA Certified
3 Shareholding pattern -Giving folio no, certificate no, No of shares,% holdings ,authorised capital, paid up capital, foreign holdings -CA Certified
4 Particulars of all Directors/Partners/Proprietor
5 Name and activities of associate companies/concerns
6 Three years business plan document with projected volume
7 Organization Chart
8 Particulars of Key Management Personnel
9 Details of infrastructure like office space, equipment and manpower
10 Lease Agreement Copy
11 Business handled during the last three years – CA Certified
12 Details of experience in insurance broking
13 Financial Information- Capital Structure, Deployment of Resources, Major Sources of Income, Income and Profit before Tax (PBT) and Dividend
14 Audited Balance Sheet for Last 3 years
15 Details of all settled and pending disputes
16 Undertaking
17 Qualification & Experience Details Of The Principal Officer
18 List of Employees Who Will Be Responsible For Soliciting And Proccuring Insurance Business
19 Details of The Fixed Deposit
20 Affidavit of PO
21 Last 3 Years Professional Indemnity Policy copies
22 Details of annual licence fees paid for previous 3 years- CA Certified
23 Any other information considered relevant- Claims handled -reported, paid, settled, rejected- CA Certified
24 copy of current licence


  • The company has _____ no. of persons in employment as on the date and will ensure to employ the minimum of 2 qualified persons in employment during the license period, who have the necessary qualifications specified in clause 9(F) and necessary experience to conduct the business of insurance broker under Reg. 9(2) ©
  • No Director / Principal Officer / Shareholder / Employee / person directly or indirectly connected with the Broking Company, has been refused in the past the grant of a license by IRDA.
  • The Principal Officer and Key Management Personnel & all the persons responsible for soliciting and procuring business, possess the necessary qualifications and the necessary Brokers Training / Renewal Training requirements as provided in Regulation 9 (F) are complied and shall be complied with at all times.
  • The Principal Officer has not violated the code of conduct as specified under Schedule III of the IRDA (Insurance Brokers) Regulations, 2002 and no complaint is filed against him as on the date.
  • The Principal Officer is appointed exclusively to carryout the functions of an Insurance Broker under Regulation 2 (1) (k) and is neither holding any Directorship / Employment / Assignment in nor represents, either on full time or on part time basis, any other Insurance related or any other entity.
  • None of the directors and employees of the company are holding any directorship / employment in or represent any other insurance related entity.
  • The Office Premises of the Broking Company and its branches are / will be exclusively used for Insurance Broking Business only and no other activity is carried on.
  • None of the Broking Company / Associate companies / Directors / Promoters / Key Management personnel / Principal Officer /Employees is holding Agency / Corporate Agency / TPA / Surveyors License.
  • There has not been any intervention by any other Regulatory Authority on the Promoters / Management / Applicant Company as on the date.
  • Note: The above mentioned list of documents and information’s are indicative, IRDA can demand additional documents and information’s. IBAI does not hold any responsibility for not prescribing any document /information demanded by IRDA.