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NIIRA 2025 / NAICOM

Overview​

FieldValue
Pack IDnigeria/naicom
Full titleNigerian Insurance Industry Reform Act 2025 (NIIRA 2025) + NAICOM Guidelines
RegulatorNAICOM (National Insurance Commission)
JurisdictionNigeria (NG)
Effective dateNIIRA 2025: August 2025; Operational Guidelines: 2021; Market Conduct: 2023
ReplacesInsurance Act 2003 (Cap I17 LFN 2004), Marine Insurance Act Cap M3, Motor Vehicles (Third Party Insurance) Act Cap M22
note

NIIRA 2025 update (August 2025) — President Tinubu signed the Nigerian Insurance Industry Reform Act 2025 into law in August 2025. It repeals and consolidates the Insurance Act 2003 and four other insurance statutes. All comply54 citation strings have been updated to reference NIIRA 2025. The NAICOM Operational Guidelines 2021 and Market Conduct Guidelines 2023 remain in force under NIIRA 2025 pending updated NAICOM subsidiary regulations.

What comply54 enforces​

Claims settlement (NIIRA 2025 §210)​

NIIRA 2025 §210 introduces a mandatory 60-day settlement deadline — the hardest claims enforcement change from the old Act.

ThresholdRule
≤ ₦500,000Auto-approval allowed
₦500,001 – ₦2,000,000Human adjuster required; auto-denial prohibited
₦2,000,001 – ₦5,000,000Senior adjuster (≥ 5 yrs experience) required
> ₦5,000,000Manual review + AML reporting
Pending > 60 daysEscalate to senior adjuster and notify NAICOM
# Claim pending beyond the NIIRA 2025 §210 deadline
result = compliance.check(
    action="approve_claim",
    params={"claim_amount": 1_500_000, "days_pending": 65},
    context={"human_adjuster_assigned": True, "senior_approval": False},
)
# decision: escalate
# → NIIRA 2025 §210: Claim has been pending 65 days — 60-day settlement deadline
#   exceeded; escalate to senior adjuster and notify NAICOM

Anti-discrimination in underwriting (NIIRA 2025 Part V / NAICOM Rule 6)​

The following characteristics are explicitly prohibited as underwriting or pricing factors:

Prohibited characteristicBasis
religionNIIRA 2025 Part V
ethnicityNIIRA 2025 Part V
tribeNIIRA 2025 Part V
political_affiliationNIIRA 2025 Part V
genderNIIRA 2025 Part V
disabilityNIIRA 2025 Part V
hiv_statusNIIRA 2025 Part V
state_of_originNIIRA 2025 Part V — explicitly prohibited; common in Nigerian underwriting discrimination cases
State of origin

state_of_origin is a documented pattern in Nigerian insurance discrimination cases, particularly in life and health underwriting. It is explicitly prohibited under NIIRA 2025 Part V alongside the more commonly cited religion and ethnicity factors. Any input that includes a state_of_origin field on an underwriting action is hard-blocked — not escalated.

result = compliance.check(
    action="generate_quote",
    params={
        "policy_type": "life",
        "coverage_amount": 1_000_000,
        "religion": "christian",
    },
    context={"human_underwriter": True},
)
# decision: deny
# → NIIRA 2025 Part V / NAICOM Rule 6: Underwriting or quote uses prohibited
#   discriminatory characteristic 'religion' — remove this field

Life insurance underwriting cap (NAICOM Guideline 18)​

AI agents may not autonomously underwrite life insurance policies above ₦5,000,000.

result = compliance.check(
    action="approve_underwriting",
    params={"policy_type": "life", "underwriting_amount": 6_000_000},
    context={"human_underwriter": False},
)
# decision: deny
# → NAICOM Guideline 18: Life assurance underwriting of ₦6,000,000 exceeds ₦5,000,000
#   — a licensed human underwriter is required

Fraud investigation (NAICOM Market Conduct Rule 11)​

AI fraud detection may flag suspicious claims but may not autonomously conclude them. Claims with fraud score ≥ 0.65 require human investigation.

result = compliance.check(
    action="flag_fraud",
    params={"claim_id": "CLM-001", "fraud_score": 0.78},
    context={},
)
# decision: escalate
# → NAICOM Rule 11: Fraud investigation must be handled by a human investigator

Policy modification (NIIRA 2025 Part V)​

Policy terms may not be modified without written notification to the policyholder.

result = compliance.check(
    action="amend_policy_terms",
    params={"policy_id": "POL-00456"},
    context={"customer_notified": False},
)
# decision: escalate
# → NIIRA 2025 Part V: Policy modification requires written policyholder notification
#   and human verification before execution

AML reporting (NFIU / MLPPA 2022)​

Premiums or payouts ≥ ₦5,000,000 trigger AML reporting obligations enforced by the nigeria/nfiu-aml pack (also included in NigeriaInsuranceCompliance).

Input fields used​

FieldPath in inputDescription
Actioninput.action"approve_claim", "deny_claim", "generate_quote", "approve_underwriting", "flag_fraud", "cancel_policy", "amend_policy_terms"
Claim amountinput.params.claim_amountInteger (NGN)
Days pendinginput.params.days_pendingInteger — days since claim was filed
Underwriting amountinput.params.underwriting_amountInteger (NGN)
Policy typeinput.params.policy_type"life", "motor", "property", "health"
Fraud scoreinput.params.fraud_scoreFloat 0–1
Human adjuster assignedinput.context.human_adjuster_assignedBoolean
Senior approvalinput.context.senior_approvalBoolean
Human underwriterinput.context.human_underwriterBoolean
Customer notifiedinput.context.customer_notifiedBoolean

Regulatory references​