Membership Application Form-1

8/12/2019 Membership Application Form-1

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INDIAN INSTITUTE OF INSURANCE SURVEYORS & LOSS ASSESSORSREGD HEAD OFFICE: PARISHRAM BHAVAN,5TH FLOOR,

BASHEER BAGH, HYDERABAD-500 004

MEMBERSHIP APPLICATION

Name in Full (Block Letters)First Name

1.

(Middle Name)

(Surname)

Photograph

2.

Category of Membership to the Institute applied for:-

Licentiate Associate Fellow(Please Tick the correct box)

SLA No and validity period:

Signature

3.

Details of categorization by I.R.D.A.:(BRANCH) (CATEGORY) (BRANCH) (CATEGORY) (BRANCH) (CATEGORY) (BRANCH) (CATEGORY)

4.

5.

6.

7.

Fathers Name:

Nationality: State of Domicile:

(a) Age:(b) Date of Birth:

Day Month Year


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Professional Qualifications:

(a) Examinations: Year of Pass College/ University Supporters initial*

(b).InsuranceQualification

10 Address for correspondenceOffice: Residential:

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

STD Code (O) (R) Mobile

Fax No.: Email ID:

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Please indicate the no.of years you are in practice Supporters Initial*

>/= 8 >/=16 < 16(Please tick the appropriate box)

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.

9.

Educational Qualifications: Supporters Initial*( from School leaving Certificate onwards)

8.


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STATEMENT OF QUALIFICATION

Tobefilledbytheapplicant

UNDERTAKING

I solemnly affirm and declare that the information furnished above is trueand 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 ofIndian Institute of Insurance Surveyors and Loss Assessors.

I hereby undertake that if admitted as a member of the Institute, I shall bebound by the Memorandum and Articles of Association, the Rules andRegulations and Code of Conduct /Ethics made there under as amendedfrom time to time and shall abide by such bye-laws, rules, standingorders, directions, conditions or guidelines as may be laid down by theInstitute and made applicable to me from time to time.

I also undertake to abide by the decision of the Council with regard toacceptance/ rejection of my application for Membership of the Institute.

I accept responsibility for the accuracy of the particulars contained in thisapplication with regard to my qualifications and experience and agreethat if I am elected the validity of my election shall depend upon theaccuracy 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 initialsagainst items of information in this application

indicate that we confirm such information from our personal knowledge.

1........................................................... F/A ........................... ...................

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

NAME & ADDRESS MEMBERSHIP No. SIGNATURE

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*Certificates details

1.

2.

3.

4.

5.

6.

** Surveyor Licenses

1.SLA No.Valid from..to.

2.SLA No. Valid from .to.





Applications duly filled in along with necessary enclosures and fee are to be sent to thefollowing address

INDIAN INSTITUTE OF INSURANCE SURVEYORS AND LOSS ASSESSORS

5thFloor, Parisrama Bhavanam , Basheerbagh , Hyderabad 500 004.--------------xxxxxxxx-------------------

I enclose the followinga.CopiesofCertificates*,Surveyor Licenses** held by me at present and in thepastattestedbyaSupporteroraGazettedOfficer(withhisSeal)b. One passport size photograph in addition to the one pasted onapplication

c. One stamp size photo for ID-Card.

d. Demand Draft for Rs. /= drawn in favour ofIndianInstitute of Insurance Surveyors & Loss Assessors payable atHyderabad.(Please note that payments made in any other form shall not be accepted by the

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(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 LossAssessors.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 connectedwith 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 IRDAand 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 8years 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. As sociate: (i) Any person holding a valid licence issued as defined herein for a continuous period of over 8years without break and categorized as defined herein and who is in the profession of Insurance Surveyorsand 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 becomeAssociate Membership.

3. Fellow: (i) Any person who is holding a valid licence as defined herein for a period of over 16 years withoutbreak and categorized as defined herein or


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(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/-

0B

CODE OF ETHICS

Every member of this institute shall abide by the code of ethics specified by the institute from time to time. Membershiprestricted 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 andloss 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 ofiv. knowledge by attending professional courses, trainings, workshops & seminars meant for the up-gradationof the required skills.v. To uphold ethical behavior, professional reputation, credibility and refrain from making unsavory remarkscomments or grievances in public or before the press without exhausting internal professional and legalavenues.vi. To give due regard to the professional reputation of fellow members and not injure directly or indirectly theprofessional 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 ofviii. 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 thex. 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 throughshareholding 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 surveyand 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 forconsideration 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 anyway diminish the esteem and professional prestige of the Institute. Any conduct of the member which is not in line withprofessionally 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.


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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 enteredin or borne on the Register if he:

I. is of unsound mind and stands adjudged by a competent Court; orII. is an un-discharged insolvent; orIII. 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 withimprisonment or of an offence, not of a technical nature, committed by him in his professionalcapacity 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 ofprofessional 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.

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8. No member shall accept more than five interns as trainees at a time. The member imparting the training shall ensurethat the trainees are on full time basis. During the period of training, the interns undergoing training shall not bepermitted 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 organizationsinvolved in Selling or Brokering of Insurance Products or shall represent the insured in negotiations for placing theinsurance business. If, one desire to join with any Insurer Broker or Insured either on employment or retainer ship or oncontract 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 refrainfrom 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 anothermember 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 ethicswill result in disciplinary action.

Documents

Membership Application Form-1