INDIAN INSTITUTE OF INSURANCE SURVEYORS & LOSS ASSESSORS REGD&HEAD OFFICE: PARISHRAM BHAVAN,5TH FLOOR, BASHEER BAGH, HYDERABAD-500

004

MEMBERSHIP APPLICATION
1.

Name in Full (Block Letters) (First Name) (Middle Name) (Surname)

Photograph

Signature

2.

SLA No and validity period:

3.
4.

5.
6.

Category the Institute applied for:- of Membership to Licentiate Associate Fellow (Please Tick the correct box) categorization by I.R.D.A.: Details of (BRANCH) (CATEGORY) (BRANCH) (CATEGORY) (BRANCH) (CATEGORY) (BRANCH) Fathers Name: (a) Age: (b) Date of Birth: Day Month Year

(CATEGORY)

7.

Nationality:

State of Domicile:
1

8.

Educational Qualifications:
( from School leaving Certificate onwards)

Supporters Initial *

9.

Professional Qualifications: (a) Examinations: Year of Pass College/ University

Supporters initial*

(b).InsuranceQualification

10

Address for correspondence Office:

Residential:

(Please tick the appropriate box) Office Residence Note: If not ticked, all correspondence will be addressed to the residential address

STD Code

(O)

(R)

Mobile

Fax No.:

Email ID:

11

Please indicate the no.of years you are in practice

Supporters Initial*

>/= 8

>/=16

< 16

(Please tick the appropriate box)

12 13

Apart form being a surveyor, whether engaged in any other profession / occupation/activity. If yes, please attach details Yes / No

Whether the applicant was at any time suspended / debarred by any insurer / organization, and if so, the reason and period of such suspension /debarring to be furnished in detail.

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UNDERTAKING I solemnly affirm and declare that the information furnished above is true and correct. I further declare and affirm that I have not attracted any of the disabilities as mentioned in Article 12 of the Articles of Association of Indian Institute of Insurance Surveyors and Loss Assessors. I hereby undertake that if admitted as a member of the Institute, I shall be bound by the Memorandum and Articles of Association, the Rules and Regulations and Code of Conduct /Ethics made there under as amended from time to time and shall abide by such bye-laws, rules, standing orders, directions, conditions or guidelines as may be laid down by the Institute and made applicable to me from time to time. I also undertake to abide by the decision of the Council with regard to acceptance/ rejection of my application for Membership of the Institute. I accept responsibility for the accuracy of the particulars contained in this application with regard to my qualifications and experience and agree that if I am elected the validity of my election shall depend upon the accuracy of such particulars as required by the bye-laws of the Institution.
Witness my hand this ........................... of .......................... year..

Signature of the Applicant

.....................................................................

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SUPPORTERS RECOMMENDATION( * SHOULD BE A ASSOCIATE /FELLOW MEMBER)

We the undersigned, recommendMr/Mrs........................................................as in every respect a proper person to become a Fellow/Associate/Licentiate of the Institute. Our initials against items of information in this application indicate that we confirm such information from our personal knowledge.
NAME & ADDRESS MEMBERSHIP No. STATEMENT OF QUALIFICATION SIGNATURE

1........................................................... F/A ........................... Tobefilledbythe applicant

...................

2...........................................................F/A ............................

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I enclose the following a.CopiesofCertificates*, Surveyor Licenses** held by me at present and in the pastattestedbyaSupporteroraGazettedOfficer(withhisSeal) b. One passport size photograph in addition to the one pasted on application c. One stamp size photo for ID-Card. d. Demand Draft for Rs. /= drawn in favour of Indian Institute of Insurance Surveyors & Loss Assessors payable at Hyderabad. (Please note that payments made in any other form shall not be accepted by the

*Certificates details 1. 2. 3. 4. 5. 6. ** Surveyor Licenses 1.SLA No.Valid from..to. 2.SLA No. Valid from .to. 3.SLA No. Valid from .to. 4.SLA No. Valid from .to. 5.SLA No. Valid from .to. 6.SLA No. Valid from .to. Applications duly filled in along with necessary enclosures and fee are to be sent to the following address INDIAN INSTITUTE OF INSURANCE SURVEYORS AND LOSS ASSESSORS 5th Floor, Parisrama Bhavanam , Basheerbagh , Hyderabad 500 004. --------------xxxxxxxx------------------ 4

 (Annexure 1) About the IIISLA The Indian Institute of Insurance Surveyors and Loss Assessors (the Institute) was incorporated under Section 25 of the Companies Act, 1956 with its registered office at Hyderabad. Objects of the Institute To promote quality in the profession of Surveyors and Loss Assessors through education and training, facilitate introduction of best practices amongst its members and to disseminate technical information amongst its members to upgrade their skill and knowledge. 1. To conduct professional examinations relating to the profession of Surveyors and Loss Assessors. 2. To promote research and studies in loss control and minimization techniques and measures and share the same with the Insurance Industry and general public and to update its members on application of new technologies for improving service to the users and consumers. 3. To bring out guidance notes, instruction manuals, periodicals for the use and benefit of members and others connected with the profession of surveyors and loss assessors. 4. To develop and administer the code of conduct and ethics from time to time with the concurrence of the IRDA and ensure compliance of the same by its members and also ensure that the members maintain/adhere to high standards of integrity, transparency, discipline and professional conduct. Membership The membership of the Institute is restricted only to individuals who is holding a valid Survey and Loss Assessor license and who are duly categorized to practice as an independent Insurance Surveyor and Loss Assessor and is not in the employment of any insurer i.e. no Institute or partnership firm or Proprietary concern or an employee whether part time or full time any entity time of any entity, company, firm which expression shall include an insured, or an insurance Company or a repairer or automobile dealer firm or any entity should be eligible for membership. Types of membership 1. Licentiate Member:- (i) Any person holding a valid license issued as defined here under for a period of less than 8 years and categorised as defined herein and who is in the profession of Independent Insurance surveyors and Loss assessors, or (ii) any person qualified to be a surveyor having undergone training, examination prescribed in the regulations who is granted the membership by the Institution as per regulations in force and on payment of prescribed fee, to be eligible for grant of licence by the authority (IRDA). 2. Associate: (i) Any person holding a valid licence issued as defined herein for a continuous period of over 8 years without break and categorized as defined herein and who is in the profession of Insurance Surveyors and Loss Assessors or (ii) any person upon passing of such examination and completion of such training as may be prescribed and having completed the prescribed duration of 8 years of holding license continuously, without break and have paid the prescribed fee for becoming members of the Institute, shall become Associate Membership. 3. Fellow: (i) Any person who is holding a valid licence as defined herein for a period of over 16 years without break and categorized as defined herein or 5

 (ii) Any person upon passing of such examination and completion of such training as may be prescribed and have paid the prescribed fee for becoming the member of the Institute, and having completed the prescribed duration of 16 years of holding licence continuously without break shall become Fellow Member. Membership fee: One Time entry fee - Rs.5,000/-Plus Fee for Annual membership: (a)Fellow: Rs.2,000/-(b) Associate: Rs.1,500/-(C) Licenciate Rs. 1,000/CODE OF ETHICS
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Every member of this institute shall abide by the code of ethics specified by the institute from time to time. Membership restricted to only independent Insurance Surveyors and Loss Assessors who is duly licensed and categorized. 1. In particular and without prejudice to the generality of the foregoing the code of ethics shall include the following: i. To exhibit the identity card and/or the license issued by the Authority while carrying out the job of survey and loss assessment and be physically fit to undertake rigorousness of the job. ii. To conduct the survey job in a transparent, fair and objective manner free of personal interest or prejudices, and ensure that the professional and technical standards of competence are upheld. iii. To endeavor continuous professional development by keeping abreast of the changes and advancement of iv. knowledge by attending professional courses, trainings, workshops & seminars meant for the up-gradation of the required skills. v. To uphold ethical behavior, professional reputation, credibility and refrain from making unsavory remarks comments or grievances in public or before the press without exhausting internal professional and legal avenues. vi. To give due regard to the professional reputation of fellow members and not injure directly or indirectly the professional reputation or practice of other members. vii. To bring to the knowledge of the council of the Institute if a member comes to know of any act of viii. unethical, illegal or unfair practice of a fellow member. ix. To ensure professional conduct at all times in a manner which will not prejudice professional status or the x. reputation of the Institution. 2. No member shall canvas for the work by unfair means. 3. No member shall take the work of survey & loss assessment where he or his family members are interested through shareholding or employment or business dealings. 4. No member shall involve himself in outsourcing of claims related work or survey work and undertake a work of survey and loss assessor on contract basis in any manner. 5. No member shall attempt or agree to carry any work on reduced or lesser survey fee of the prescribed fee schedule. 6.No member shall allow use of his/her name and license number to any other person or lend his/her survey reports and other documents for direct or indirect use by the other person or to any other licensed surveyor whether for consideration or reward or for any other purpose. 7. No member shall write or express any statement, views or opinions or give publicity to anything, which may in any way diminish the esteem and professional prestige of the Institute. Any conduct of the member which is not in line with professionally acceptable norms or contains deliberate acts of disobedience, unlawful behavior, neglect of duty & malfeasance will include among other matters to be misconduct and violative of the code of ethics.

 8. No member shall accept more than five interns as trainees at a time. The member imparting the training shall ensure that the trainees are on full time basis. During the period of training, the interns undergoing training shall not be permitted to work anywhere either on part-time or full time or on contract basis 9. No member shall engage in any employment of any professional Insurers, business groups or trade organizations involved in Selling or Brokering of Insurance Products or shall represent the insured in negotiations for placing the insurance business. If, one desire to join with any Insurer Broker or Insured either on employment or retainer ship or on contract basis, the member will surrender his membership of the Institute immediately. 10. Publicity: In any publicity material used in advertisement, circular or other form of publicity, the member shall refrain from claiming any superiority in any respect over any or all other members unless such claim can be substantiated 11. Recruitment: No member shall either directly or indirectly make any approach to any person on the staff of another member with a view to make him move to his own firm. 12. Members are expected to adhere to the code of ethics strictly in letter and spirit. Any breach of the code of ethics will result in disciplinary action.

Disabilities* under the Article 12 of Articles of Association of the Institute Notwithstanding anything contained in these Articles, a person shall not be entitled to have his name entered in or borne on the Register if he: is of unsound mind and stands adjudged by a competent Court; or is an un-discharged insolvent; or being a discharged insolvent, has not obtained from the Court a Certificate, stating that his insolvency was caused by misfortune without any misconduct on his part; or IV. has been convicted by a competent Court of any offence involving moral turpitude and punishable with imprisonment or of an offence, not of a technical nature, committed by him in his professional capacity unless in respect of the offence committed he has either been granted a pardon or, or an application made by him in his behalf, the Council has, by an order in writing, removed the disability; or V. has been removed from members of the Institute on being found on inquiry to have been guilty of professional or other misconduct. Provided that a person who has been removed from membership for a specified period, shall not be entitled to have his name entered in the Register, until the expiry of such period and except on an application being made for that purpose and on payment of any fee or other amount that may be a recovery from him. -------------------XXXXX-----------------------I. II. III.