Insurance Surveyors and Loss Assessors (Licensing, Professional Requirement

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TI-IE GALEnlcOl· INDI/\ EXl RJ\ORDINARY INSURANCF. REGULATORY AND DEVELOPMF'iT At:THORITI NOTll'ICATION !\cw Delhi, 1hc 201h '-Jovc111bcr 2000 ln,urance Suncyors and Lo~, As,cs,ors (Liccntinj!. Profcssionnl Rcquircn,cnts and Code of Conduct) Rcgulati11n,. ?Ollll F'. No. IRD/\/Rcj!./11/20110.- In exercise of 1hc powers conferred by sccttons 42D. 64UM and I 14A of the Insurance A-Cl, 19S8T4 of 1938) ~nd section 26 of u,c Insurance Regulatory and Devclopmen1 Au1hority Ac~ 1999 (4 1 of 1999). 1he Autho, ii). in consuhation ,_,th the Insurance Advisory Comm111se, hereby makes 1he following regula1io11s, n,unel)':• CHAPTJ.::R I PRELlll-·11N.\RY I. Short rit(e, commencrmtnl anti application ( I J These regula1ions may be called the ln;urance S1mcyol' anJ Lo» Assessors (Licencing, Professional Requiremen1sand Code ofConduc1) Regular,ons. 2000 (2) They shall come into force on the dare of their publicauon in the Olficral Gazcue and shall apply 10 all licensed insurance surveyors nnd l<>SS assessors. 2. Definitions.- In 1hc.se regulatious. unless the context otht:n'-·ist requires.• (a) "'Act" means the Insurance Act. 1938 (4 of 19,8). (b) "applicnnr· means any petS<>n who applies for rhc grant of•• surveyor's and los~ asscssQr's licence or renewal ,hereof; (c) ··Authority" means 1hc Insurance Regulatory and Ocvdoprnent Authority established under sub• section ( I) of section 3 of 1he Insurance Regu la1ory and Development Authority Ac~ 1999 (4 1 of I 999); ' (d) "Designated Person•· means an omcer of the J\ulhorit~ dct>ikd by rhe Authority 10 doscharge the funcuons assigned to h,m under all or any of1hesc rcg1ila1ions, (e) "Inspecting Authorl1y" 11,cans lhe pcrson(s) appoin1ed by the Authority 10 inspect and investigate the affairs of any surveyor and loss a~~essor; (f) "IRDA Act" means the Insurance Rcgula101y and Dcvelopmenl Aulhority Acl, 1999 (4 1 of 1999): (&l wcrd, and expressions used and not defined in these regulations bul defined ,n the Insurance Act. 1938 (4 of 1938) or lnsurnnce Regula1ory and Development Authority Acl, 1999 (41 of 1999) or the General Insurance Busrness (Natio11alisa1ion) Act, 19i2 (57 of 1972). or in an) rules or regulations made under tho,e ActS, shall have 1hc meanings respecuvely assigned to 1hem in !hose Acts or rules or regulations. as 1he case may be .. 1 - - - J CHAPTER II LICENSING PROCEDURE 3. Application for. nnd matters rcla1iug to, granl of licence ( I) Every person who is an inJividual and in1ending 10 act a, a surveyor and loss assessor in respect of general Insurance business shall apply 10 the Au1hori1y for gl'aill of licence in FORM-I RDA• I• Ai' as given ,n the Schedule Lo these regulations. (2) The Authority shall, bcforc granting licence, take into consideration all matters relating 10 the duties, responsibilities anJ !'unctions or surveyor and loss assessor and satisfy itself that the applicant is a fir and proper person lo be gra.nted n licence. In particular and without prejudice 10 the foregoing. the Authority shall satisfy itself that the applicam, in addition 10 submitting the application complete in all respects:• (a) satisfies all the applicable requ1l'emoms ofscetion 64UM read wi1h section 42D of1he Act and rule 56A of the Insurance l(ules, 1939: (b) possesses such additional technical qual llicatio,1s as may bt spccitocd by the Authority from time to time: (c) has furnished evidence of payment of fees for grant of licence. depending upon the categorisation; (d) has undergone a peri<>d of practical 1rainrng, not c,cceding 12 months, as contained in Chapter VII of these regulations: and (e) furnishes such add11ion,1I 111fonnation a, may be rcquir<d by the Authority from time to time. (J) The Authority on being ,atisii~d 1hat Lhc applicant is cligibk for grant of licence. shall grant the same in FORM-IRDA-2-LF d> given in the Schedule LO 1hese regulations and send nn intimation Lo Ll1e applicant together with an identity card mentioning the panicular class or category of general ins1,Jrance business namely. fire, marine cargo. marine hull. engineering.~ motor. misccUancous and loss uf profit for which the Authority has granted licence and the licence shall remain valid for a period of five years from the Ja1e of issue thereof, unless cancelled earlier. (4) A surveyor and loss assessor, whose licence has been cancclkd or suspended for any reason, may subn1i1 an applica1ion for issunnce of licence. alkr the expiry or three years from the dale of such cancella1ion or suspension, and, such an application shall be treated as a fresh case. and, accordingly, the applicant shall satisfy all the requirements of,ub-regulaiion (2). (5) A surveyor and loss assessor shall be subjec1 to cmegorisation as specified in Chapter V of these regulations. (6) A licence issued, before the commencement of these regulations. by the Controller of Insurance or his au1horised representative shall be deen,ed to have been issued in accordance with 1hese regulations. 4. Corporate Surveyors and Loss Assessors ( I) Where the nppl icant is a company or flrm, the Authority shall be satisfied that all the directors or panncrs, as the case may be. possess one or more of 1he qualifications specified in section 64UM( l)D(i) of the Act and none of such directors or partners. as the case may be, suffers from any of the disqualifications memioncd in section 42 D of the Act read with Section 42(4) of the AcL (2) The applicant referred to in ( I) shall apply in FORM-IRDA-3-AF as given in the Schedule to these regulations, )5 36 THE GAZETTE OF !NOIA : EXTRAORDINARY ll',\J<T 111- SEc 4 I (3) The Authority on being satisfied that the applicant is eligible for grant of licence, shall grant the same in FORM-IROA-4-LF as given in the Schedule 10 these regulations. and. all the provisions of regulation 3 above, shall apply mutalis murandis to corporate surveyors. 5. F'tt Structure On and &om May I, 200 I, the fee payable to the Authority by fresh applicanis for grant of licence to act as surveyors and loss assessors, category wise, shall be as stated In lhe following table: S. No. Category of surveyor and loss assessor I. 2. 3. A 8 C Amount payable by individuals Amount payable by Corporate Rs. Ten thousand Seven thousand five hundred Five thousand Surveyor and Loss Assessor Rs, Twenty five thous.ind Twen!)' thousand Fifteen thousand 6. Application to conform to lhe requirements Any incomplete application not conforming to the requir~menis of these regulations shall be rejec1ed. Provided that before rejecti11g any such applscniion, lhe appliran1 shall be given a reasonable opportunity 10 make goO<! lhc applica1ion. 7. Renewal or licence ( I) An insurance surveyor and loss assessor, desiring to renew rhc licence granted earlier, either under these regulations or prior to 1he conunenceme111 of1hese rcgulmions, shall apply ro 1he Authority a1leas1 lhirty days before the expiry of rhe period of validity 1hcreof. in FORM-IRDA-5-AF (for individuals)/ FORM-IRDA-6-AF (for corporate surveyors) ;as given in lbe Schedule ro these regulations, aJongwlth a rentwal fee of two hu11drcd rupees Provided that the Authority may, if ir is sac is tied 1hn1 undue hardship would be caused 01hcrwise, accept any application, w11hin six months oflts expiry on pay111cn1 by 1hc applican1 ofa penally of seven hundred and fifty rupees. Provided further rhar a lice11ce not so renewed can be revalidated only as a fresh case. (2) A licence so renewed shall be valid for five years from 1lte daoe of renewal, unless cancelled earlier. The renewed licence shall be in FORM-IRDA-7-LF or FORM-IRDA-S-LF. as the case may be. (3) Every applkanl, be ir an individual or a company or a firm, while applying for renewal of 1he licence shall certify 10 the Authority that he or any of its directors or any of ics partners. as 1he case may be. has: (i) not concravened any of 1hc provisions of the Act or the IRDA Act, or any rules or rcgulailons made under those Acts or any order or dircc1io11 issued by Lhr Au1hori1y: (ii) not made a statement which is false in material particulars with regard 10 his eligibility for the licence or renewal thereof or in any of the activities transacted by him or them or the matters connected therewith as a Surveyor and Loss Assessor; (iii) neither had his licence cancelled or suspended under the Act, nor had violated the Code of Conduct prescribed under these regulations; (iv) discharged the duties and responsibilities as a professional: (v) not been negligent in the discharge of his obligations; (vi) not been sentenced 10 a term of imprisonment by any Coun of law. 8. Procedure where licence is not to be granted or renewed, or where licence is to be suspended or cancelled ( I} Where an applicant does not satisfy the provisions of the Act and these regulations, the Auth<>rity may reject the application for gram of licence or renewal thereof and refund 10 the applicant 1101 more than 60 per cent of the fee received; Provided that no application shall be rejected unless the applicant has been given a reasonable opponunity 10 make good the applicatio11 within a time frame as may be deemed appropriate by the Authority, according to the facts and circumstances of each case. (2) I he refusal shall be communicated ltl the applicant within ~,irty days or such refusal, siating the grounds of rejection. " (3) Where it is found that a surveyor and loss assessor suffers from any of the disqualifications or has ~nowingly contravened auy provisions of the Act or the IROA Ac1. or the rules or regulations made under those Acts or any order or direction or i11s1n1c1ion issued by the Authority. the Authority may, aficr givlng ~ucb surveyor and loss assessor an opponunity of being heard. cancel his licence, wilh effect from such date as ma:,, be specified by it and the Authority shall notify such cancellation in the Official Gazelle. (4) Th(: Authority may refuse 10 grant or ren-:\, licence. or ~uspend or cancel a lict.'nce a.lrcady granted, to a ~urve}1or and loss n%cssor, ifhe:/ it· (i) fails 10 discharge the duties and responsibili11es in a sa1isfoc10ry and professional manner; or ( ii) viola1es the code of conduct prescribed under these rcgu lat ions; or (iii) makes a statement which is false In material pa111culars with regard to the eligibility for obtaining licence or has, alter the issue or renewal ol' such licence, acquired any of the disqualifications provided undtr sub-section (•I) of section 42 or the Act, read with clause D of sub-section (I) of section (>4LJM of the Act Provided th,,t the Authorit) shall g,ve a rc;isonahk opportun11y. to the person concerned, of being heard, before such refusal or suspension or cancdlat,mL The Authority shall no1iry only cancellations in the Otlicial Gazelle. Provided further that the pO\\lrs conferred on the Au1horny in this sub~rcgulation are without prejudice 10 1l1e powers c,•aferre;I on it by sub-secuon (7) of section MUM of the Act. 31 THE GAZETfE OF INDIA: EXTRAORDTNARY [P,\RT Ill-SEC. 4 J (5) The refusal or suspension or cancellation of licence referred to in sub-regulation (4} shall take effect f\-om the date of such refusal, suspension or cancellation, as the case may be, and, no such surveyor and loss assessor shall carry out any survey and loss assessment work thereafter. including the jobs on hand. All such pending jobs shall be returned by him/ it to the insurer or the insured, as the case may be. 9. Suspension of the licence (I) A licensed surveyor and loss assessor whose licence is proposed to be suspended by the Authoriry may be granted an opportunity before suspending the licence. Provided, however. that the Authority may not follow this procedure if the continued employment of the licensed surveyor and loss assessor is considered 10 be detrimental to the cause of insurance underwriting. (2} The period of suspension will be indicated in the order of the Authorily. (3) On receipt of the order of suspension, tbe lice□sed surveyor and loss assessor may file an appeal with the Authority asking for revocation of suspension. The Authority may designate an officer who will hear the representation of the licensed surveyor and loss assessor and make such orders as are deemed fit. The order made in this regard shall be communicated to the suspended surveyor and loss assessor. • (4) If, on 1he basis of the order of the designated person. the Authority restores the licence of the surveyor and loss assessor. it will indicate the date from which the restoralion will take place. (5~ During the period of suspension, the surveyor and [OS$ assessor shall be prohibited from carrying out aay surveys and all wor~ that was handled prior to suspension and has remained incomplete shall be returned 10 an insurer or the insured as the case may be. (6) The licence granted by the Authority may be cancelled by 1hc Authority where the surveyor and loss assessor does nor represent within a period of 45 days from the date of order of suspension. (7) Any order of suspension or revoca1ion of the order thereof shall be intimated to the insurers. 10. Issue of Duplicate Licence/lderttily Card (I} A person to whom a licence has been issued or renewed. shall, if such lice.nee and/or Identity Card is/are lost, destroyed or mutilated, make an application in FORM-IRDA-9 given in the Schedule to these regulations to the Authority requesting for issuance of duplicate thereof. along with a fee of five rupees. (2) The application referred 10 in sub-regulation (I) shall contain ful l particulars of licence/identity card and as 10 how the loss/destruction or mutilation has occurred, and the application shall be accompanied by mutilated pieces, if any. In possession of the person making the application. (3) The Authority, on being satisfied. may issue .a duplicate licence and/or identity card in FORM- IRDA-10-LF a, given in the Schedule co these regulations. (4} The duplicate so issued shall remain in force for the remainder of the period of validity of rhe licence and/or identity card. unless cancelled e:arlier, and the duplicate shall bear an endorsement I hereon chat it is a duplicate • L CHAPTER Ill CONSTITUTION ANO FUNCTIONS OF SURVEYORS AND l,OSS ASSESSORS CO1'1-1MITTEE, I J. Consritution ( I} The Authority $hall constitute a Committee to be called "Surveyors and Loss Assessors C:ommi11ec" (herein after referred LO as "the Comminee"), for assisting the Authority on the matters an<l affairs relating to Insurance Surveyors and Loss Assessors. (2) The Comminee may consist ol'the following pcrsons:- (i) an Ol'ficcr of the Authodty; (ii) two represemativts of the Surveyors and Loss Assessors: (iii) a representative of Insurers: (iv) a represenrative of the policy holders: (3) The Committee will be for a period of three years and will be presided over by the otliccr of the Authority. 12. Functions of the Comm illee.- (I) The Commince shall perform the following functions:- (i) recommending the syllabus for examination and practical training requirements for persons to qualify as surveyors aud toss assessors; (ii) recommending to the Authority for its consideration to recognise foreign qualifications and training for the purposes of grant of licence to ac1 as surveyors and loss assessors; (iii) improving and developing the status and standard of lhe profession of surveyors and loss assessors; (iv) co-ordinating with educational or other institutions, having as their objects, wholly or panly, similar to those of the profession of surveyors and loss assessors, in such ma11ner as may be conducive for the atlainment of comm011 objectives• (v) looking into the matters of profess.ional misconduct, indiscipline, non-adherence to code of conduct by surveyors and loss assessors; and dealing with complaints of insured/insurer in respect of survey work done by surveyors and loss assessors; (vi) discharging any other function, which rnay be entrusted by the Authorily, from time 10 time. (2) The Committee may meet as frequently as necessary to conduct its affairs. (3) The members of the Commi11ee, other than the officer of Authority will be entitled lo such allowances as may be determined by the Authority from time to time. 39 .I() TUE GAZETTE OF INDIA EXTRAORDINARY CHAPTER IV DUTIES ANO RESPONSIBILITIES OF A SURVEYOR ANO LOSS ASSESSOR 13( I) A surveyor and loss assessor shall. fur a major pan of lhc working time. 111vcstiga1e. manage, quanti(v. vulida1c and deal wi1h losses (whe1hcr insur~d or not) arising from "ny contingency. ~nd repon thereon. and carry out the work wi1h competence, objccrivity and professional integrity by strlclly acJhcnng 10 the code ofconduc1 ex~c1cd of such surveyora11d loss assessor (2) The following. shall. 111/er al/a. be the duties and responsibilities or a surveyor and loss asscssor:- (i) declaring wherher he ha.s any in1e1·e-s1 in th~ subjec.l•m.iuer in ques1km or whether it penains 10 any of his relatives, businc~s r,anncrs or through materi:11 shar~holding; Explanmior. Por tht: purpose or thi~ clau!)e ·relatives· shall mean any of the relative~ as mentioned in ~chcduk IA IO the Companies Act, 1956; (ii) maimaining ctmfidemiality and neutrality withou1 jcopnrdising 1he liability of the insurer a.id claim of the insured; (iii) conducting inspection and re-inspection of the propcr1y in question suffering a loss. (iv) examining, inquiring. investigating. verifying and checking upon the causes and the circumstances of the loss in ques111m mcluding ex1en1 of loss. nature of <>wnership and insurable i!llerts1; (v) conducting spot nnd lin:11 surveys. as and when necessary and comrnen1 upon franchise. cxcess/tmder insurance and any other rcla1ed matter: (vi) es1imating. measuring arid dctem1ining the quantum and description oflhe subject under loss; (vii) advising the msurer and the insured about loss minimisa1ion. loss control, security and safety measures. wherever appropria1e, 10 avoid (uniter losses; (viii) commeming on the ad111issibili1y of lhe loss as also observance of warranty conditions under the poltcy con1rac1: (ix) surveying and assessing the loss on behalf of insurer or insured; (x) assessing liability under the contract of insurance: (xi} poin1ing out discrepancy, If any. in the policy wordings; (xii) satisfying queries of tbc insured/insurer and of persons connected thereto in respecl of the claint!loss; (xiii) recommending applicability of depreciation and the perccnl3ge and quantum of depreciation; (xiv) giving reasons for repudiation of claim. in case the claim is not covered by policy terms and conditions; (xv) taking expen opinion, wherever required; (xvi) commenting on salvage and i1s disposal wherever necessary. (3) A surveyor or loss assessor shall submit his repon 10 1be insurer as expeditiously as possible, but not later than 30 days of his appointment. Provided 1ha1 in exceptional cases. the afore-mentioned period can be extended with the consent of the insured and !Ito insurer. CHAPTER V CATEGORISATION OF SURVEYORS 14(1) /\ surveyor and loss assessor shall be categorised. as mentioned in sub-regulation (3). based on 1he fol lowing criteria: (i) professional qualilica11ons: (ii) 1ra111111g undergone: (iii) experience as a survc~or and loss assc.ssor and any other relevant professional experience~ \iv) any other criteria. as may be specified by the Authority from time 10 time. (2) The ca1egorisation shall be done and reviewed from time to time on the basis of a point system evolved by the Authority in consulta1lon with lhe Committee referred tom Chapter Ill of these regulations. (3) l'he categorisation shall consist <lf ullocauon of one or more specified depar1mcnts of insurance business, based on the factors mentioned above and shall include categorisation of the surveyors and loss assessors into three categoric,. vi, •. category A. Category 13 a11d Ca1egory C. (4) F,very surveyor and loss asscsso,, whether a company or firm or an individual, shall be eligible to carry on the work as a surveyor or loss assessor, as per the categorisation specified in the licence. CHAPTER VI CODE OF CONDUCT 15. Every surveyor and loss assessor shall- ( I) behave ethically and with integrity in the professional pursuits. Integrity implies not merely honesty but fa ir dealings and truthfulness: (2) strive for objectivity in professional and business judgment; (J) act impanially, when acting on instructions from an insurer in relation to a policy holder's claim under a policy issued by that insurer, (4) conduct himself with oounesy and conside.ration 10 all people with whom he comes into contact during the cQurse of his work: (5) not accept or perform survey works in nreas for which he does not hold a licence; ( 6) not accept or perform work which he is nol compel en! lo undenake, unless he obtains some advice and assistance, as will enable him to carry out the work competently; (7) carry oul his professional work with due diligence. care and skill and with proper regard 10 technical and professional standards expected of him; (8) keep himself updated with all developments relevant to his professional practice; (9) at all limes maintain proper record 'for work done by him and comply with all relevant laws; 3224 Gt/2()()()--0 41 THE Gi\ZEl,E OF l>JDIA: EXTRAORDINARY (IO)assist and encourage l11s colleagues to obtam professional qualllicauons. and, i11 tins bchalC provide free 11rhdcsh1p and/or prac1ic,1I u-nmmg for a period of twelve.-. months: ( l I )mau11ain -a reg..tster of sur\'(') ,,ork. containing lht: rclevam jnformation, in FORM-IRIJA-11 as g1vt11 111 the ~chcdule to these rcgul,11,ons, and ,hall keep impo11am records of 1h~ survC)' rcpons. photogrnph;; :lnd other 1tnpuna111 documcms for a period three years ;1nd furnish the same and such other c;,pec,fiecl l'~1u1·ns, as i'ind whcu tailed for by the Au1hority or by any mvesugnung authortt) or the m,;:urer 1 l1)d1sc1osc 10 nll parucs conccrn~d his. appointmcm. where the accc.ptan<:c.: or continua.nee of such an cn~-;"l_gcmcnt ma, matcri::ilt~ p1,.;_p1<lice. or could be seen to ma1crir,lly affect the inlercsts of any ,m..:,.:stcd parl) ,\s soon :is a conl1ic;c or intc1\!st is fol'esecn. e,,cr>· surveyor and loss ClSS\'SSor shall 11011fy all 11Hen,!stt..·<l pnrlies 1mn11:d111rely and seek instructions fo1 his condnuancc: { 13) not disclose- au) mforma1io1L pe1ta1uing to a clitnt or cmployl'r or policy 110l<ler acquired in 1he course of his rrofc"-sional wo1 k. co mi, Ihm.I pHrly, e.:xcep1, where consenl h~s been obtained from 1he 1111~rested party. or where there 1:i. a leg-al right or duty enjoined upon him to disclose: t14}ncl11h:r ust:-nor appear ,o use. i'!!I) co11fiLIC1Hi3l information acquirt'I..I or rc:ccived by him in the C(H1n;e nf his profession-a( work. to his pe.:r~o,wl advantage or for the advnntngt.' of;:1 third p i111y CIIAl'TER Vil l'RACTICAL T RAINING I<• (I) A11 apf)lic.111< :sct:king a lk~n~e tu act as a surveyor and los~ as'.)c!isor shall undergo n period of prac1ical trnioing of not l.:ss than twelve months ,v-ith a surveyor ;ind los.$ assessor as specified ht!l11\\ (2) The surveyor under whom an applicant will be rraincd shall belong to category A or category Bas cl.-i:i.:i.ifkd b~ 1he Authori1:, \vhil~ granting.a hcencc: (3) Th..- trainee shalJ 1l1~1intain a record of !raining r~.ceivcd during 1hc period and shall ge1 it cenified by tl1c surveyor and loss a"essor under whom he has trained and the cenilicate shall be attached to Lht.' applicai-ion for s1.:ddng gn;mt of n Hcencc under rcgula11011 3; ( ~) The lie en cc- to be grnmeU tu :in applicant to act :1s a surveyor and loss ::isscssor sha II be in that partic1,..11:.lr area for which he hns been tniincd: \5 I If n surveyor and loss assessor already hccns~cl by the Au1l1orit) steks 10 obtain a similar licence for acring as a surveyor in a category other than for which he is licensed. he sltHII undergo a pcrio<l or 1r:,,ining no, less than six mooch!. u111..la a surveyor and loss assessor holding either Category A or Ca1egory B licence issued by 1ht· Au1hority ro act in thm particular area I 7. The Authority 11i.1y nlso ptescribc the passing by atl applicant of on examination on the successful complctton of the trarnrng prescribed above for the graht or a licence under Regulation 3. The exarni11a11on may be conducted either by the Authority itself or by nn institution authorised by it in this behalf G f CHAPTER VIII MLSCF.LLANEOUS 18. Reglsccr or Liecnscd lnsunmct· Sun·eyors anti Loss Assessor~ (I) rhc Authority shall maintain a register of i.Ll1 licensed in.sunmce :;urveyors and loss as~c~~or'.:> contam1n~ the following pa1·ticulars:• 1i) full name. dntc of bll'lh. domicih:. rcsidemial au<l professional ~<l<lrcss: lii} the date on which name is t:nlcn.:d 1n the Rcgi~tcr. (iii) licence number and period ol'v<1lidl1y; (iv) profossioual and other qu:ihlka1ions. (v) oreas of sun·~y work licc.'nM!d to be uudc:rt:iken: (vi) c~1cgorisation of ~hl' surW:)'Ur and lo!:is assessor: (vii} any olh~r paniculars J~ nm} be prescribed bj 1hc Au1hon1y fiom time to ume. Provldt!d th.it in the cnse tlf corporaI1,.• surveyors. the particulars to be cntl·rc<l 1n the register, sh.:sll be wuh reference 10 l!vi:ry director or p:m.ncl' ii~ the case .inay be {2) The Authonty shall. di.:lcll' ch;.: partkular5t of survl:'yors and h1:,s as:;cS"sors. who are no lungct olive. or whose liccnc.c has been cancdktJ or suspcndc<l. (3) The Au1horit) ,hall cause 1hc 1mblicmion of1hc rckvan1 panicul.irs e111ered in Lhc rtg,sicr as ma;, b" c(lnsidl·rcd appropri:1t1: by h. at such intervals and in such manner, as 111~\y be deemed lit. 19. Submission or rNurns-.F,·cr)' lic(.'nse.J survc)·Or amt loss ais.Cs!'ior shall:- (n) fomi~h Mith of lhc document, sialcmcIU. :ic-counl. n.:tuIn or report. as and '"·hen 1<:qu:11; b; the Aulhol'it>·• and comp!)' ,vith such directions. a." may be i~srn:d by the /\u1honlv 111 1h1s behalr. from lime h> 1ime. and (b) submit an annual srn1e111cn1 iu FORM-IRDA-12 given In the Schedule 10 1hes< rc~ula11rn:s 10. Inspection ( I) The AuLhority. 11Hl) i1ppoin1 unc or more persons as inspecting au1hori1y to undcnak~ msp~c11-...1:1 i)I ~urvey work books, record~ and documents. or to investigate any hn,w jide complaim rcce1,·ed against a surveyor and loss assessor {2) The inspec1ing au1horll~ shall. as soon as possible. submi1 an inspection rcpor1101he Authon1y (3) (4) The inspecting au1hori1y shall be given all information demanded b)' II for the purpose of carrymg out inspectionlinvcstigmion w<)rk. and shall be extended all possible co-operation, 10 facilitate rhc conduct of i1s work. The Authority shall. after consideration of 1hc inspection report. communica1c the find111gs of the inspoc1ing authori1y t<J the surveyor and loss assessor. and shall also give h'°t a reasonabh: opportunily of being heard before any action is 1aken b)' 1he Au1hori1y on the findings of 1he inspection report. 21. Power to clarify In case of any douht 01· ambiguity in reg;ird 10 any of 1hese rc:gula11ons. 1he same shall be clarified by 1he Chairperson oflhe Au1hori1y To Si,. I. TIIE GAZETTE OF lNDIA EXTRAORDINARY SCIIEDlfLF: INSURANCF. RF.C:lJLATORY AND DEVELOl'MENT AUTHORITY FORM - IROA - I -AF !Sec Regulation 3(1)1 APPLICATION FOR A LICENCE TO ACT AS SURVEYOR AND LOSS f_SSESSOR rasspo11 S i,.c lns;urnnce Regulatory unJ DtvL'lupmcnl Authority Gate No. 3, Fir~t Floor. Jcc\'RO Tara Bldg .. 5. l'Mliamcnt Street, New Delhi- 110 001. Telephone No. 3364711. Phol0. (3+1) I rrqucsl thal a licence 10 act as a Surveyor and Loss Assessor may be gf3nted to me for the fol lowm_g classes. De ts Fire Mrn Car o Mm Hull En Motor Misc. LOP L Please tirk 2 1. I enclose a Demand Draft No. ____ Dated ____ Drawn on _________ _ toward!. payment of foes. I hereby declare Iha!. i) I have not been found h > be of unsound mind by a Court of competent jurisdiction ii) I have rtot betn found guilty of criminal misappropriation or criminal breach of trust or chcMing or forgery or of abcimcnt or anempt to commit any such offence by a Cou11 of C,1mpctcnt Jurisdiction. iii) I bavc not been found guilty of or to have knowingly panicipated in or connived at any fraud/dishonesty or mi~reprcsentation against an insurer or an insured in the course of any judicial proceeding rdating to any policy of insurance or tht winding up of an insurance company or in the course of any investigation of the affairs of an insurer. iv) I shall not violate the code of conduct specified by the regulations made by the Authority. v) I possess the requisite qualifications and practical 1raini11g as specified by lhc regulations made by the Authority. vi) I have passed such examination as specified by the regulations made by the Authority. vii) I enclose 4 passpon size photographs. (Please also enclose an affidavit nffirmii>g clauses (i) to (vi) duly notoriscd.) 4. I also declare that 1J1e paniculars given below are true: (IN BL,OCK LETTERS) a. Full Nnme (in Hindi & English) ------------ -·--------------------·-·---······-·-···· Shri/$ml/Kum. ----·-----------------------------------····-···-·· b. Father' siHusband • s Name ---------------------------------------····-···· - c. Full address in Hindi with PIN CODE ........... · -·----------------------------------- d. Full address in English with PIN CODE --·····---···-·-········-------------------- 5. Qualification a) Academic/professional b) Insurance c} Training attended (Nature - duration} 6. Communication I!!!!! ' J 45 Phone Office Phone Res. fax Pa2er Mobile E-Mail 7. Date ofBitth 8. Practical Trainine. Details (Please enclose the ccnificate oftrafoin• obtained from the survevor/ surve" firm) Name of Depanments Category P-eriod of 1raini11g Name of Areas Result Surveyori Allocated lo the Awarded to the undergone (Please person(s) covered Survey Firm Surveyor/ Surveyor/ mention dates) under whom Survey Firm Survey Firm training undertaken 9_ Experience: n) Whether the applicant is employed with any insurance company; ____ _ b) Job Experience in previous employmcot other tlm1 insurance surveyor. if any;_ c) Details of other business/ cmploymeni: ______ _ 10. Whether the applicant possesses any ol"the following qualifications: Yes/ No. If so give details and also enclose either the original diploma cenificatc whit one copy each or copies of original diploma duly attested by a Magistrate or Notary Public. (Where original diploma/ Certificates arc sent they will be returned after perusal but no responsibility can be accepted for loss or damage of such originals): (a) holds a degree of a recognised University in any branch or Engilleering. (b) Is a fellow or associate mc111ber of the lnscicute of Choncrcd Ac-countants or India or the Institute of Cost and Works Accountants of India, (c) Ac111arial qualifications or holds a degree or diploma of any recognised university or institu1e in ,elation 10 insurance_ (d) Holds a diploma in insurance granted or recognised by the Government. (e) Possesses any of the technical qualifications mcnuoned in Rulc-56-/\ of1he Insurance Rules, 1939. 11. (a) Are you employed? If yes. please give details. (b) Are you under the employment of a Govemment/Scmi-Government Organisation or any ocher Public Sector U11de11aking, Private Organisation? Give details and auach No Objection Ccrcificatc of your present employer. (c) Experience; Job experience in chronological order of employment. 12. Have you ever held a licence 10 act as a surveyor and loss assessor" If so. state number and date and a11ach a photocopy of the Licence No .• SLA date of issue. If the Licence is required in the name of the Sole Proprietorship Firm. full name and address or the firm under which the individual proposes 10 carry on the work shou Id also be mentioned here. Yours faithfully Signature of the Applicant CHF.CK LIST Pltase ensure: I) llrnfl in favour of Insurance Regulatory and Development Authority. payable at New Delhi. 2) llegreei Diploma allested by Notary/ Magistrate only. J) Affidavit duly notarised againsl S.No. 3 of the applicauon form is a must. 4) Self addressed envelop of4S" x 10 .. with Rs.17/- posrngestamps. 5i Please enclose attested documents 111 response 10 Q. No.'s 5, 8. 9. 10 & 11 the answers to which nre a must. (, Please attach 4 ass ori size hoto!!.ra hs with the a . I icauon. 46 THE GAZETTE OF INDIA : EXTRAORDINARY IPAltr Ill- SEC +I Notes I. The attention of the applicant is drawn 10 Section 102 of the Insurance Act 1938, which provides that whoever in any document required for the purpose of any of the provisions of the Act, rules or regulations made thereunder. fails to furnish the same shall be liable to a penalty not exceeding Rs. 5 lakhs for each such failure and punishable with fine, 2. An individual can apply for only one licence, whicll will entitle ltim 10 acl as a Surveyor and Loss Assessor for any insurer. 3. Any correction or alteration made in answer 10 the questions in 1hc application should be ini1ialed by lhc applicant. ~- An appltcant must be a1leas1 18 (eighteen) years of age on the date of submission of1he application In 1he case of any applicant declaring that he is 18 years, the exact date of birth should be stated against item 4 of 1he application. !f require the applican1 shall furnish proof age. 5. The fee as specified in the Regulation should be p:aid by means of Account Payee Demand Draft in favour of Insurance Regulatory and Development Authority. New Delhi drawn on the Indian Overseas Bank. Parliament Street Branch, New Delhi. Fee Structure: The following scale of fees shall be payable to IRDA from lhe fresh applicanlS for grant of licence. S.No. Ca1egory of Surveyor a11d Loss Amounl p:iy:1ble for Individuals (Rupees) Asse.ssor I. A Ten Thousand 2. B Seven Thousand five hundred 3. C Five Thousand O lfchc foe is made for a category of 5lirvcyor and loss assessor licence \\hich involves payment of lughcr sum of money and lhe Authority graril5 a licence whQse cate~ory involve, paymem of l11wer foes lhe AUlh0rit) shall refund 1he balance to the apphcant w11hin a reasonable period of time through a crossed cheque in favour of the applicant. 7 The applicmion complete in all resp.:ct along with bank drali and the ceniticates aucstcd by ;, Magistrate nr ,, No1,1ry Public should be fo,·warded b~ the applicant 1(1 the following address by Regis1cred Post: -, he Insurance Ri:gu!mory anti Dev~lopmcnt Authority Gate No. 3. Fir~t Floor. Jecvan Tara Building 5, Parliament Streel. New Delhi- I JO 00 I. Tel. No. 33647 11 Enqui,·y Between 1500 hrs. 10 1600 hrs. As the li~nc.: is issued bilingual vii __ In Hindi and English, the applicam may like 10 indicale how he spells h,s name in Hindi. 11 is 1herefore, requc, tcd that 1hc name and address may he wrillen both in I lindl & English 8. Payment In Cash or by Money Order, Cheque. Postal Order, Posrage or Insurance Stamp is not accepted and will be returned al applicant's cost. 9 No acknowledgement of this apphc~uion will b1.: !;en1. If OnC" 1s required lhe application shouh.1 be '$ent b) registered post (acknowlt"dgcment due) IO An affidavit duly notorised on non-judicial stamp paper is required to be furrushcd fo,· both fre,h and renewal o( licences in 1hc form of a dee lar:1tion u, contained against S.No. of3 of the applicauon form. 3 INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY NOT TRANSFERABLE FORM - IROA -2- L.F (Sec Rcgul:a1ion 3(3)1 LICENCE NO ......................... . LICENCE TO ACl ,.<\SA SURVEYOR AND LOSS t\SSF.SSOR UNUJ!R THE INSURANCE /\CT. 1938 Mr.I Mis./ ti.o1iss ....... .... ..... .. ................. , .... . Address House No ......... ... .. Srrect. .. . I own/ District ........... State ........ Pi1u:odl• ... ... . Passpnn size Phow 47 • \,orkmg as sole proprietor of ...... .•. •• • . , .... ...... ... .. , .. ... ... ........ hi:1,•m_g, pnld che specified fe~ and having m~de the nrci:-ssar) clcclaration is hereb) authon".'.>1.'d undc1' St:ctmn 64-UM o( lhe Insurance i\c.1, 1938 to ace as surveyor nnd loss a:,s~:-;sur for a pel'iod of five Yl"ars lhun .. .. .. . .. . . . . . . . . . . . . . .. . . . . .. . .. , This L1ccncc: will expire on .... . , . •. . . . . . . .. Nmnt: ..... i$ allocated the following dcpal'llnenls and category: Oe ts Fire Mrn Carot1 Mrn !lull En'°· Mo1or Misc. LOP Cncruorv New Delhi, da1cd 1hc , , ..... 10 ..... ~ig,na1ur~ of lhc L1c~11cc lwldcr Dcsig.uat~d Person lnsuranc~ Regulatory an.d Dcvctopmcru Authori1y (See Notes on the reverse} Jr ll is Jc~m:-J 10 renew this licence for a further pcl'iot.J, the procedure stat~d 111 tht: Regul:uions sht1II b.: fr,llowt!d, and an applica1ion for renl.'wal should n.:ach the AutlHlrit} a.Hli:ast thirt)' d:\ys beforl: lhL" liccw.:l' l':\pir~s 2. l'his lict!nct.> auLh<,1nscs the licence h,,Jder 10 act as a surveyor and fuss n.ssessor l<.u· any registered in~un:r and th\!refor\!", no idcn1il)1ing ll131'" 01· note or any description by which the identity of un msurer mighl he C'\tahlishi:d should bl! p1ac~d ..:,n 1hc licence. 3 No correction in thi~ licen~e .shall be v~tli<l unless inhialletl by the Dcs1g.nati:d Pc,son of the /\u11mrity. To 11-!E GAZETTE OF INDl1\ : EXTRAORDINARY INSURANCE REGULATORY ANO llEVELOl'MENT AUTHORITY FORM-IRDA-3 - AF (Sec Regulation 4(2)1 jPAKI Ill-Sa~. 41 APPLICATION FROM A FIRM OR COMPANY FOR A LICENCE TO ACT AS A SURVEYOR AND LOSS ASSESSOR J!\surancc Regulatory and Development Authority Gate No 3. First Floor, Jcevan Tara Oldg. 5, Parliamem Street. New Delhi-I 10 001. Tel. 3.164711. o~.ar Sir. It is requested that n I ice nee 10 act as a Surwyor nnd Loss 1\ssessor ma)• be granted IO our Firm/ Company for the following departments :ind category. !De IS Fire MrnCa o MrnH ull En ·, . Mo10r Misc. LOP Pk:1se tick The rct-e1pt No ............... dated .......... from ............ ,howing payment of fees of Rs. __ is enclosed. 2. 11 Is hcret,y declared that- (i) no direcior/ partner of our Company/ Firm has been found 10 be of unsound m,nd by n Cour1 ot' compeient jurisdiction, (ii) no director/ partner or our Company/ Finn ha, been found guilty of criminal mbappropri:11ion or criminai breach of trust. or cheating or forgl!ry, or an abetmem of or atttlllpl lo commit any $Och offence by a Coun of competent jurisdiction; (iii) no director/ pan11c1· of our Company/ Firm has been found guilty of or 10 have knowing!)' panicipoted in or conniv~d at any fraud, dishonesty or n1isrcpn.•st:n1ation agains1 an insurer or an insured in the course of any judicial procecdi11gs rela1ing to any policy or insurance or the winding up ofan insurance company or 111 the course or an investigation of the affairs of an insurers; and (iv) no director/ partner or our Company/ F'inn is a minor (v) no director/ partner of our Company/ l'irm shall violate the code of conduol specified by th rcgulattons made by the Authority. (vi) all director(s)/ partner(s) of our Company/ Fim1 possess the requisite qualilications and practical training as specified by the regulations made by the Authority. (vii) all di,·cctor(s)/ partner(s) persons of our Company/ Finn have passed such examination as specified br the regulations made by 1hc. Authority. ~. II is also declared 1ha1 the paniculars g1Ven below are tn1e. I. full name of the applicam I. Company/ Firm ______ _ (In Olocl- Leners in llindi & English) 2. Fu II Address 2. (In Hindi & English) 3. The names or all the directors/ partners. with their addresses stating in each case the date ofbinh and whether they claim to:- (a) have been in practice as a surveyor/loss assessor on the 31" May. 1970, or (b) hold a degree oia recognised university in any branch of engineering, or (c) be a fellow or associate member of1he ------------- 3. ------------ (a)----------- (b) _________ _ (c ) ------------- ( (3) A surveyor or loss assessor shall submft his report to the insurer as expeditiously as possible, but not later than 30 days of his nppointment. Provided that in exception31 cases. the a.fore-mentioned period can be extcndt,d with the consent of the insured (tnd 1he insurer. CATEGORISATION OF SURVEYO RS 14( I) A surveyor (Ind loss ;issessor shall be cntegorised, as mentioned in sub .. regulation (3). based on the followin~ criteria: (i) professional qualifications; (ii) 1raining undergone; (iii) experience as a surveyor and loss assessor and any 01her relevant professional experience; l•V) any other cl'ircria. as may be specilied by the Authorit) from time 10 1irne. (2) The categorisation shall be done and reviewed from time to time on the basis of a point system evolved by the Authority in ct\nsullation with the Comminec referred t◊ in Chapter 111 of1hese regulations. (3) 771c categorisation ,hall consist of allocation of one or more specified depar1111cnts of insurance business, based on the factors mcn11oned above and shall include categorisation of 1he surveyors and lqss assessors into three categoric!:., viz., Category A, Category 8 and Category C. (4) Gv¢ry s111v¢yor and loss assessor, whether a company or (irrn or an individual. shall be eligible to carry 011 1he work as a surveyor or los~ assessor, as per the categoris:.11ion specified in the licence. CHAPTER VI COO£ OF CONDUCT 15 Every surveyor and loss assessor shall- ( I) behave ethically and with integrity in the profossional pursui1s. Integrity implies 1101 merely honesty but fair dealings and 1ru1hfulness: (2) strive for objectivily in professional and business judgment; (3) act impartially, when ac1ing on i11s1ruc1ions from an insurer in relation 10 a policy holder's claim under a policy issued by that insurer: (~) conduct himself with counesy and considera1ion 10 all people with whom he comes i1110 con1act during 1he course of his work; (5) not accept or perform survey works in areas for which he does not hold a licence; (6) not accept Qr perform work which he is not competent 10 undtnake, unless he obtains some advice and assistanc.e, as will enable him to carry out the work competently; (7) c.arry ou1 his professional work wi1h due diligence, care and skill and with proper regard 10 technical and professional standards expected of him; (8) keep himself updated with all developments relevant to his professional practice; (9) at all times maintain proper record 'for work done by him and comply wilh all relevant laws; 3Z24 Gl12C-00-6 41 12 'I I IE GALE1TE OF INDIA · EXTRAORDLNARY )PAKT IJI-SF.C. 41 ( IO)ass"1 nnd encourage hos colleagues 10 ob1a111 proless,onal qunlificauons. and. in 1his bch,,tr. provide free nnicleship and/or practical iranlulg for a period ort,,.•clvc mo111hs: ( I l)ma1111.:i111 a register ofsurvc) work. contam111g the- relevant informauon, ii, FORM•fROJ\·11 a~ given 111 the SchcJuk to thcst rl.!gulauons. ond shall kl!cp iinponanL records of the survcy reports. photographs an<l other i mporl~1n1 docurncnts ror a period ch rec years and furnish the same and such other spcc1tied ri:turns. as und wh.:n called fo1 by th.,c Au1horit}' 01· by any investigating. authority or the lllSUtc.!r l I 2>d1sclose co aJl p;inics concc1·n1.·tl his appointment, where the acceptance or continuance of such ,111 l'ngugcm.:01 m~t.:,. mJtcnall) pn:1udkc. or could be: Sl!C:n to materially affect the interests. of :my 11Hcrested pan: ,h sonn as ~1 co11nicr of iutcrest is forCSl·Cn. l.'vcry surveyor ::md loss ass1tssor shall 11011fy u1l 1111.:re~1ed panics inmw-d:(U<:ly rind seek i1,structions for his con1inuancc~ < I ])not disl~losc nny 1uformatt0n. p1:11.iming to a client or employer 01 policy holder a.cquited in lhc course or his profossional work. IO ,m, lhird p,ir1y except, where consen1 has been ob1ainc~ from Lhc 1nrcrcstcd purly. or ,,here thcr~ ts .1 legal rig.hi or duty enjoined upon hint to disclose: (i -1 )neither US!;! nor appca1 10 use, <.lny conlid.:ntinl information acquir~d or r'"c:civcd b)· him in the course tjf his professional wo1k. to his pt.:r!>t•lhll ndvuningc or for the adv~nrng'i!' ofa 1hird party. CHAPTER VII PRACTICAL TRAINING 16 ( n Afl applican1 seeking a 111.:t.·ncc to net as o sm·veyor and lo~s Hsscssor shall undergo a period of pr;:ic1ical training, of 1101 1c~:- than twelve months w11h c1 survc.,,or :md loss ~ssessor as specil1cd ht."kH\-' - " (1) The surveyor under whom :in :-tpplican1 will he trained shall belong to caccg.ory A or c::negory B c1s classified by tht Authoruy \\ hile granting a l1cencc; 0> The rra1net shall maintain a rt:cord of training received during 1hc p,mod and shall get it certified by the surveyor and los:i;; nsse-ssor und<-r whom he hiis trained and the cenifkatc shall be attnched to ,hi: application for 5cc.king_ grant ofa licence under regulation 3: (•I) The I iccntc 10 be gramed 10 an appl icani 10 act as a surv~yor and loss assessor shall be 111 1hu1 panicular an.:::i for which he l1as been tramcd; (~) ll'a survoyor and loss assessor already licensed by 1he Awhori1y seeks t<) obtain a s1111ilar licence for acring as a surveyo1 1ll a category other than for which he is licensed. he shall undergo a period of muning. nol lcs.s 1hnn six months under a surveyor and Joss assessor holding either Category A or Ca1l!gory B licence issued by ttu: Authority 10 act In that particular area. 17. The Au1hori1y may also prescnbe 1h~ passing by an applican1 of an examl11a1ion 011 the successful romplcrion of che 1ra111ing prescribed ,ibovc for lhe gram of a licence under Regula1ion 3. The examinn:ion may be conducced ei1hcr by 1h,, Au1hori1y i1self or by an insti1u1ion au1horised by ii in 1his behalf [ 'WT 111-,;;rn; 4 I CHAPTER VIII MISCELLANEOUS 18. Register of Licensed lnsurancc Sur"cyors and Loss .-\ssessors ( 1) n,c Au1hority shall nrnintam a rcgi.ster of all lict.!n::.cd insurnnc:t? .surveyors and loss assess.ors comaining ihe following particulars:• (i) full name. date of birth, domicile, rc:;i<lcntinl .1nd pruf1.:::.~il)1t.1l addn.'SS. {it) the dmc on which name is .:mered in 1he Register; (iii) licence number and period ofvalicl11y: (iv) pr(>frss1011al and oiher qualiti.ca11011s. (v) an:as of su1 vcy work liccu:-,.<.•d lO be undertaken; (vi) catcgonsation of the survc>·o1· and loss a.~Sc!>sor: (vii} ~my oiher pnniculnrs t.1s in.I) be prescribi:d b) the Authority rrom. time to time 11rovu.kd thm in 1hc cnse or corpornte surveyors. Ilk parcicul:1rs tu be c1Hcr~d in 1hc rcgislcr, shall b ... · ~\·ith referenet· to every director or par1n..-r as the ciisc 1m1y be (1) Tiu: Au1hority shall. di:lcce- the panicular~ of survl!}·ors and lv~.s assessors. who lire no lunger nli\'(.', or whose hci:nce h:\s hccn cancclfc<l ,,r suspc11dcd. ~ (3) fhe .ti.urhorit} stw.11 cause th~ public;;1tioo of lhc rt!ll!\'UDl pani-culnrs entered ln tht: legi'it..:r u:-- may b:.: <.:onsidered appropriatl.' by it, m such intervals and in such rnam1er. as m:t}' be dccntcd n1 l 9. Submiss-lon of return$•.F'Ve[) iict:tlscJ surv~yor and luss asscs.-;or ~hall · (3) furnish such of tht: <lo!..·umcnt. sHste.ml'lll, account. rc1uru llr l'cport, us unJ ,\•h1:1t l'eqH111,;\! h1 the Aulhonty, and c,,mpl) with sud, directions. as may be issued by 1hc Au1hun1, 111 11,,, behalf. from lillle 1n 1imc. and (b) submi1 au 01111ual statement in FORM-IRDA· 12 given in 1hc Schedule 10 these rcg11lu1M,s 20. lnspcc1ion (I) The Authority, may appoint one or more persons as inspecting au1hori1y to undertake i11,pccu,,n "' survey work. books, record!) 1H1d documents, or to inves1igntc any br>na fide. complaint recc1vc;J against a surveyor and lo~!) 3S!)Cssor. (2) I he inspec1in~ autl1ority shnll, as soon as possible, sub.nil an inspection report 10 the Aulhonl). {3) The inspecting authority shall \,e given all information dcnrnndecl by it fo,· the purpose of carr)'ing out inspec1ion/inwstiga1ion work, and shall be extended all possible co-operation. to facilllatc the {4) conduct of its work. , The Authority shall, afier consideration of the inspection rcpon. communicate the finding~ of the inspecting 3\llhority 10 the surveyor and loss assessor. and shall also giv~ hltn a reasonable opportunity of being heard before any action is taken b) 1he Authority on the findings of the inspection report. 21. Power 10 clarify In case of any doubt or ambiguity in regard to any of these regulations, the same shall be clarified by the Chairperson of 1hc Authority. To Si1. THE GAZETTE OF INDIA EXTRAORDl'JARY SCHEDULE INSURANCE REGULATORY AND 0 EVELOl'MENT AUTHORITY FORM • IRl>A - I - AF !See Regula 1io11 J( I )I APPLICATION FOR A LICENCE TO ACT AS SURVEYOR ANO LOSS ASSESSOR Passport Size Insurance Reg11la1ory and Development Authorily Gr1te No. 3. Firsl Floor. Jeevan Tar~, Bldg., 5. Parliamen1 Stree1, New Delhi• I IO 00 I. Telephone No, 3364 71 I, Photo. (J+I) I. I request that a licence to act :is a Surveyor and Loss Assessor mny be granted to me for the following clnsscs. Oc HS f'irc Mm Caro Mm Hull En . Mo1or Misc. LOP Plca$c tkk 2 I enclose a Demand Drafr No. ____ Dated ____ Drawn on _________ _ towardi payml'.nt uf foes. \. I hernhy declarn that. i) I have no! been found hl be of unsound mind by a Cour1 of competer!I jurisdiction. ii) I have. nut been fOund guihy of criminal misappropriation or criminal breach of trust or chcatwg or forgery or o-f abelment or attempt to commit any such offence by a Cour1 of Compch.'nt Jurisdiction. iii) I have not been found guilty or or to have knowingly participated in or connived at any fril\.ld/dishonesty or misrepresentation ngainst an insurer or an insured in Lhc course or an)' judicial proceeding relating 10 any pol fey of insurance or the winding up of an insurance company or in the course of nny investiga1ion of the affairs of an insurer. iv) I shall no! violate 1he code of conduct specified b> 1he reguln1ions made by the Authori1y. v) I possess 1he requisite qualifications and prac1icnl training as specified by the rcgula1ions made by the Au1hority. vi) I have passed such examination as spccilled by 1he regulations made by the Authority. vii) I cnci<)Sc 4 passport s,zc pho1ographs. (Please also enclose an affidavit affirming clauses (i) to (vi) duly notorised.) 4. I also declare thal 1he particulars given below are irue: (IN BLOCK LEn·ERS) a. Full Name (in Hindi & English) ·······--··············-···-············-········ Shri/Smc/Kum. •• •··········-· .•••••.•.•••. ·--···· •••••••••.•.••• b Fa1her's/Husband's Name •-·-·--············-········--······-······-· c, Full address in Hindi with PIN CODE ··········· ··-··· ··-··········-·········· ···-···· d, Full address in English with PIN CODE ·············-·····-·-·····················-······ 5. Qualilicmlon a) Academic/professional b) Insurance c) Training auended (Nalure - duration) 6. Communication 45 Phone Office Phone Res. Fax Pae.er Mobile E-Mail 7. Date of Bi 1th 8. Practical Training etails (Please e11c ose t c cent 1ca1e o tra1n1ng obtaine rom, e surveyor surve finn) Name of Departments Category Period of training Name of Areas Result Surveyor/ Allocated to the Awarded 10 the undergone (Please person(s) covered Survey Firm SurvC)•0r/ Surveyor/ mention dates) under whom Survey Firm Survey Firm training undertaken D h . fi f d f, h I 9. Experience: a) Whether the applicant is employed with any insurance company: _ ___ _ b) Job Experience in previous employment other than insurance surveyor, if any: _ c) Details of other business/ employment. ____ __ _ 10. Whetherthe applicant possesses any of tl1c following qualifications: Yes.I No. If so give details and also enclose either the original diploma certificate with one copy each or copies of original diploma duly attested by a Magistrate or Notary Pualic. (W.here original diploma/ Certificates are sent they will be returned after perusal but no responsibility can be accepted for loss or damage of such originals): (a) holds a degree of a recognised University in any branch of Engineering. 11. (b) Is a fellow or associate member of the lnstiw1e of Chartered Accountants of India or tl,c lns<itute of Cost and Works Accountants of India. (c) Actuarial qualifications or holds a degree or diploma of ,rny recognised 1miver$ity or instiune in relation to insurance. (d) Holds a diploma in insurance granted or recognised by the Government. (e) Possesses any ofthe technical qualifications mentioned In Rulc-56-A of the Insurance Rules. 1939. (a) Are you employed'/ If yes. ple.1se give details. (t,) Arc you under the employment of a Govemmcn1/Semi-Government Organisation or any other Public Sector Undertaking, Private Organisation? Give details and attach No Objection Certificate of your preS<nt employer. (c) Experience: Job experience in clmmological order of employment. 12. Have you ever held a licence l<) ac1 a-s a surveyor a.nd loss a.~scssor? If so. state number and date and attach a photocopy of the Licence No., SL.A date of issue. If the Licence is required in the name of the Sok Proprietorship Firm, full name and address of Lhe firm under which the individual proposes to carry on the work should also be mentioned here. Yours faithfuJly Signaturt: of the /\pplicam CHECK LIST Please ensure: I J Draft in favour of Insurance Regula1ory and Development Autbority, payable at New Delhi. 2) Degree/ Diploma attested by Notary/ Magistrate only. 3) Affidavit duly notariscd against S.No. 3 of the applic.ition form is a must. -1) Self addressed envelop of 4.5" x 10'" with Rs. 17/- postage stamps. 5) Please enclose attested documents in response to Q. No.'s 5. 8. 9, 10 & 11 the nnswers 10 which are n must. 6) Please attach 4 ass on size hot02.-a hs with the a lication. I THE GAZE11'E OF INDlA ; EXTRAORDINARY [PART JU-SE<:. 41 Notes I. The anenrion oftbc applicant is drawn 10 Section 102 ofthe Insurance Act 1938, which provides that whoever in any document required for the purpose of any of the provisions of the Act, rules or regulations made thereunder, fails to furnish the same shall be liable to a penalty not exceeding Rs. 5 lakhs for each such fai lure and punfahable with fine. 2. An Individual can apply for 01tly one licence, which will entitle him 10 act as a Surveyor and Loss Assessor for any insurer . .l. Any correction or alteration made in answer to the questions in the application should be initialed by the applicanL 4. An applicant must be at least 18 (eighteen) years of age on the date of submission or tho application. In the case of any applicant declaring that he is 18 years, the exact date of birrh shou Id be stated agamst 11cm 4 of the application. If require the applicant shall fumish proof age. 5. The fee as specified in the Regulation should be paid by means of Account Payee Demand Drafi 1n favour of Insurance Regularory and Development Au1hority, New Delhi drawn on the Indian Overseas Bank. Parl-iamen1 Street Branch. New Delhi. F'ee Strucrurc: The following scale of fees shall be payable ro IRDA from the fresh applicants for grant of licence. S.No. Category of Surveyor and Loss Assessor Amount pa) :iblc for Individuals (Rupcrs) I. A Ten Thousand 2. B Seven Thousand 11 ve hundred 3. C Five Thou,and 6. If the foe Is made for a category ol surveyor and loss assessor licence which involves payment of highc-r ~um of monC)' and the Authority grants a licence whose category involves pil)'lllcnt or lower fees the Authority shnll refund the balance 10 the applicant wi1hin a reasonable period of time 1hrough a crossed cheque III favour nfthe applicant 7. The upplicntion complete in all respect along with bank drafl and rhe ccnir.ca1es auested by n Magistrotc 01 n Notar) Puhlic should be forwarded b) the applicant 10 the following address by Registered Post. rhc- Insurance Regulatory and Developmen1 Authority Gate No. 3, First Floor. kcvan Tnrn Bllildmg 5, Parliament Street, New Delhi-I JO 00 I. rel. No. 3364711. Enquiry Between 1500 hrs. to 1600 hrs. /\s the licence ts issued bilingual viz .. m Hindi and English. the applicant may like to indicate how he spells his name in I lindi. It ,s therefore. requested that the name and address may be Wl'inen both in Hindi & English. 8. Payment in Cash or by Money Order. Cheque. Postal Order. Postage or Insurance Stamp is nor accepted and will be returnod at applicant's cost ') No ncknowledgcmcm or this ~pphcauon \\·ill be sent. If one is required the application sh()Uld be sc111 b)· r,..-.gistcrcd post (acknowledgement dueJ 10. An al'lidavit duly notoriscd on non-judicial stamp paper is required 10 be furnished for both fresh and renewal or licences in the form of a dcclarntion ns coniaine<.1 against S.No. of J of the npplica1ion form. INSURANCE REGULATORY ANO OEYELOPMSNT AUTHORITY NOT TRANSFERABLE FORM- IRDA-2- Lf' !See Re~ula1ion 3(3}1 LICENCE NO ...................... .. .. LICENCE TO ACT AS A SURVEYOR AND LOSS ASSESSOR lJNDER TIIE INStlRANCE Al7. 1938 Mr) Mrs./ Miss ....................... . , .. Address I louse No ............. .. S1ree1. .. , ......... . Town/ District ........... State ...... , .. Pincode .. ... . f>asspon 5iLL'. Pho10 -17 • working as sole propnetor of ...... ..... , .. . .... .. ., ........... , . h:wmg paid the sped tied foe and having made the nece~sary dcclarn1io11 is hereby :101hon~cd under Sec1ion 64.-llM of the lns.urancl! Act. 1938 10 act as surVC)'Or and loss o.ss~ssor fi>r .t pe-riod or tivt: years Imm . . . . . . . . .. .... , ..................... . . This Uccnce will i.::xp1re on , .. , , __ Na1ne ................... , .. ............. . "-11,:\\ ()clhi1 dated thl" .. 20 Si,;na111re nl'thc l.icrncc hold~, • (S11 ike out ,f no1 required) . IS- alloc~ted the following departments and caIegory: Moior Misc. LOI' Designated P~rson lnsurance Rcgulawry aud l)cvelop1m:nt Authori1y (Sec No1cs on 1he «verse) Noles Ir 11 is desired to renew dtb licence for a further period, 1hc procedure sia1cd in 1hc Rcgul:iiions ~hall be IOUowed. ;md :m applic:ttion for 11.!'llc\val .should reach thl" ;\mlH.H uy .i1le:1s1 1hirty days b('forc 1hi: llecnct' l'.Xpil'C::,. 2~ rh,~ licence nuthori.ses thL' hc.:nCL' holder lo ac1 as il surveyor aud loss :-:is~essor ror .my n.cgi'llcrc<l ln!>ttrl.!r .mJ thl"rcforc, no idenrifying mark or note of any description by winch the iden1i1y of an msurl'I might be established should he placed on 1hc licence. J.. No correction in thi~ licL'ntc: shall b~ valid unless iniLiallL'd b>· 1he Designated Person of the Authority, INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY NOT TRANSFERABLE FORM - IRDA-2 -LF JSee Regul·a1ion 3(3)1 LICENCE NO . ... .................... .. LICENCE TO AC I AS A SURVEYOR AND LOSS ASSESSOR UNDER THE INSURANCE /\CT. l<J3g Mr.I Mrs.I M is;......... .... .. . .. . .. .. . .. ... . .. . . . . ... . Address I louse No...... . .. .... . S1rce1. . ............. .. Passpor1 size Pho10 47 Town/ D1smct , .... ...... State... . .... Pim:ude-..... , .. working as sole proprietor of . , . . ... ... , . .... , . . ...... ...... , ... having paid the spcc:ilied tee and haviRg 111ade the nec.css.i.Jr)'' d~claration is hereby auchoriscd uncle, Section 6-l-UM of the ln::;urani:-c /\Cl. 193 8 to act as surveyor rind loss ;i:,~c:-...sur for a pt"riod of live }'-l:Drs from .. . . . . ........... ........ .... ..... .. .. . I his I. icencc will expire on ......... Name Fire Ne" Delhi. dilled !he ......... :!O .... . S1g11a111re of1hc Lic~ncc hold~r • ( Stri"c 1.ml ff not n:quircd) is alloca1cd 1hc fol lowing dcparunen1s nnd taicgory, .:;M=rne....:.H:..:u:.:1:...1 --l-E=' :.:"=·--+"'M.:;oe,lc,,o.:;r _ _ -f--!M=i':.:·c.:;, ---l 1,9 P Designated Per,011 lnsnranct: Regulatory and 0L"vdopmcm /\u1hont) (See Noles on Ll,e reverse) No1es 0 '-- 11 it 1:-. -..ksircd 10 r~J1ew lhis licence for a further period, the procedure staled iu the Reg.ub11ons shall be lollt>,\l!d. ;_md nn application for n.·ncwal should re:i.dt lhc- Authorit~ ~\tlt:ast lhirty days bt:forc the licence 1:xpin.:~. :? n u~ licence .iuthoriscs lhL· licence hvlck r 10 ac1 us r.i survey<)r and loss assessor fbr riny 1c~istercd insurer and thL·rcf-Or<..'.. no identif)'ing ina,k or 1101.: of any di.::Scription by wluch the identity or nu rnsurer n11ght be c,wbl,shed should be placed 011 1he licence. i No ..::orrec1ion in this lictnce shall be vahd unless inilia!kd bi the Dcs1gnarcd Pl:rson or,hc Authonty. To THE GAZE'TTE OF INDIA EXTRAORDINARY INSURANCE REGULATORY AND OEVELOPMEN·1 AUT HORll'Y FORM -IRDA-3-AF !Sec Rcgulalion 4(2)1 IP\RT 111-S,.tc. 41 APPLICATION FROM A FIRM OR COMPANY FOR A LICENCE TO ACT AS A SURVEYOR AND LOSS ASSESSOR Insurance Regulatory and Dcvdupm«11 Authority Gate No. 3, Firs! Floor, Jeevan Tara Bldg. 5. Parliament Street, New Delhi-I JO 00 I. Tel. 3364711. It is requested 1ha1 a licence to ace as a Surveyor and Loss Asses!)or mn} be granted to our Firm/ Company for the fol l<1wing tlepartments and category. ;...:.D:.:l'=l>:..' ---1-l':..i::.r.::e ___ +-"11-"-1'-'ri"-1 .:,C::;a::.,,r !L.;...:.M=.rl::.l ..:.H:..:u:::lc:..l ~e-"E.:.:n.,_· •o,;•c_--+..:;~c.:.10::.tc,Oc:.r __ -l-M=is"-'c"-. ---+-"L'-'o'-'r'-• --- Please tick The rccc,pr No . .......... ..... daled ........... from ......... .. showing payment of fees of Rs. __ is enclosed. 2. It 1s hereby declared 1ha1- (i) no dircc1orl partner of our Company/ Firm has been fouml 1<> be of unsound mind by a Coun of competent jurisdiction, (ii) no tlircc1orl panner of our Company/ Finn has been found gulily of criminal misappropriation or C'riminal breach of trust, 01· cheating or forg..:ry. or un abctmcnt of or attempt to commit an)· such otTc11ce by a Court of competent jurisdiction: (iii) 110 director/ panner or our CQmpany/ Firm has been found gu,hy of or 10 have knowingly par1icipa1ed in f1r co11niv1:d at any fraud. dishonesty or misrepresentation aguinsr an insurer or rm insured in the cours~ of any judicial pr()ceedings relating to any policy of insurance or the windjng up of an insurance compan) or in the course of iln investigation of 1hc affair!t of an insurer~~ and (iv) no dircc1orl panner of cur Company/ Firm is a minor. (v) no director/ partner or our Company/ Firm shall violate the code of condue1 specified by th rcgula1ions made by the Authority. (vi) all Jircc1or(s)I panner(s) of our Company/ Pinn possess the requisite qualilicmions and practical training as specified by tl1e regulations made by the Au1hority. (vii) all direc1or(s)I panner(s) persons of our Company/ Firm have passed such examinailon as spccilied by the reguhuions made by <hi: Authority. 3. It is also declared that 1he particulars given below are true. I. Full name of 1he applicant i. Company/ finn ______ _ (In Block Le11ers In Hindi & English) ' Full Address 2. ____________ _ (In Hindi & English) 3. The names of all the direc1ors.l partners. with their addresses stating in each Ca'ic the da1e of birth and whether they claim IO: • (a) have been in practice as a surveyor/lQss assessor on 1he 3 I" May, 1970. or (b) hold a degree of a recognised university in any branch of <-ngineenng. or (c) be n fellow or associalc member of the 3 (a)---------- (b) _________ _ (c) __________ _ C hc.litutc 1,1fChant.rcd Ac.count.ante.. of India l'I ln.stilutc of C'ost and \\\.rks A«.4.;0\UHilll{~ or India, ur td} pu5SC:S a1.:u.1nr"\I qu,ilitic.:Cll1Un} 01 hol<.1 ~i (d) _____________ _ di:gtt::! \ JI' d,plotnn ot fillj lnd1,111 Univ.:rsit)' or ln~umte in relation ro insmniH.:~. or {e) hold a diploma in insurance gr,uH~t.i (¢) _____________ _ or recogni1.ed by the Governmi:m. or (t) ro~sess any of the roclmical q11olilica1io11s (f) _____________ _ 1r:c1111oned in Rule "6-A 4l/ , ' I\ I In 1hc ca,c of each of the panner,;direc1ors claimin!,t 10 come under 11e111 (ll) abo,c and 1101 bemg ellg,bk to • , ll nt.· um.kt -an~ 01· 1hc ilcms. (b} w { I) ::1hcn:L• . .i declar.11 ion a,; given 111 the I nsurnncc Rukc:. 19 ll) and sworn be-fore a \,1.tl,!i,11,th."' l 11' '-'01,11~ Public should be 1Urw1Jrdt.:d and m tht: cast: orcat'h of the puru1cn,1Dm.:l:tor~ claiming lo come u1,Jcr i.my one ,--.r th..: 11c:m~ tb) to (f) aho\.<t..•. d1her th!! origi11al diplomas/ cc11 i11cmes wi1h one uf tltt..' dttc~tccJ copy 1.:Jdt. ur .. opu::, 1._11 1h"· onhmal Uirlom3s. 1.:enilicatc;:; duly attc-:-tted b) it Magistrnte or Nota,y Public should be ('t11,:lny.:J. WIH.~~·i.; t11i~iu..1.! Jip:om;.1!i-' n irutit.:atcs nrL ,em, th-ey will be rcwrncd nfler pc:w,;al. hut 110 f'.!~pon'iibility .:,1;: be JC(t<P\cd fo, lo:.!'.> u1 J<t111t.g,c df ~uLh original,; I\ n ~ Wh!!rc a Uiri:ttor/ p:J1 lltl.'r doc~ thll :tlu.-ad~ holJ a licence then an ;,,pptication from ~uch a p• ... ~iOll shoul,J ,1""1111;p.lu~· lh1 .ippl,1;Jliun 1 I · ,i..' ,1 ru· Jiw\ 1•: 1~1-..11rfiJ_1t.1H partiu1l.:ir mi1\' be given in t~ sep;mue , he"•t whi.:h ~houJd be c.i~nt!d b, the .1t r'i"--1!! I J fhc ,mJ,.,Ju;.I .Jcu,ls or all the <lirecl\,lv panners in the Company, F11111 be enclosed as per FORM-IR0-'.-3A- AF J tW.11•:J. Yours fnith rull, Sign~tun.1 of applicant (Designntioo) Name ofFirm/c()mpany. ' Uli(' oj ptt1Ce l>::u1.••t th<.: .... Cf-IF.CK 1.IST Ptt:aSt: ensur~ Seal of the Cornpany.i Firm (See Notes on tl,c reverse) I\ Oran in favour or Insurance Rcgular~1ry nnd Development Authority. payable al New Delhi. J.} Ocgrc~., LJ1p!on\J anc-stcd by Not~u, · Mag_i•q;-aie only, l / /\11ichl.\·i1 duly nomrised -against S.No 3 of the applitarion form is a mu~t 4) ~t..!f.-:ddrc5scd envelop of.:i Y' x 10" \\ith R!<i. 17/• postage-stamps. 5) l'ka~ enclose FORM-IRDA-3A-AI com k tt in all res ee1 alon• with a11es1ed 3224 Gl•?.000-7 5() THE GAZE lTE OF INDIA . EXTRAORDlN ·\RY IP-\Rr Ill- Sec. 41 Notes 1. The at.cm ion of the applicant is druwn 10 Section 102 of the Insurance Act 1938, which provides 1h01 whoever in am document required for the purpoic;e of any of tlu.• provi-.ion:; o1 1hc Act. rules or n~gulatlons ntadt: thcmmde,. fad$ to furn ish the same. ,hall be liable to a penal!) nol oxcccJ ing Rs S lakhs for each s1,ch iailurc ~md pun1.lihJhlc with tiue, 2. A linn or conipau~ con apply for Olll) one lict-nce which will entnle it 10 iwt as a -.urveyor and loss asse~.'iOf, J 1\ny corrertir,n ◊r illltratioJ1 made 111 lhc applic:11ion should he initin!Jcd by lhe applicant, -t A l~c !1S spccine,I in the: rq;,ub1ion1- .;,hould bl' paid by ll"lt:alls of J\~..:ount Payee Demand Draft in favour of ln~ul'dH<.t: Rcgul:l.1o;y nnJ Dcvdop1t1t,.•nt Aulhorit)', Nfw Delhi drnwn on Indian Overseas Bnnk, Parliament S11c,.,•t Oranch N~" Delhi. Fee StruclUre: Tl,e following scale ui' fees shall be payable tu the Authority by 1he fresh applicams for grunt of IIC..!11\.:~. Categ Asses~ fir) of Surv(.'yor nnd Lo~s ·or . ~~ - Amo11n1 p:tyable ro, ('ompnnics/ Firms (Ku pees) T,Vt:IH\' F 1v~ Thousand l'wcnt\' Thousan<l Fifteen 1 lmusand ;"\. Pnvmem in Cash 01 by M1:1ncy Or<lt•1 t'hl'(}Ut'. Po-.;•al f'lt~t:r. Posl.1£1!' or l11:,urancc !-irnmp 1s 1101 ;icccpte<l und will hl· n·tt,rncd at rtpplkJnt"s t.'('1"-C 6 If 1l1l.' r.::c i--. made f,,r a cat.:gory of ~ui vt:ytw and fos:,. assi:~sor I 1cern, ..... \\ h1:..:h I nvolv-:s payment or Ii 1ghcr sum of moaey ;.inti rhe Au1honty gnrnls a licL'rlCL· wlw,;e cah:-gory iuvc,lves p.-iyn,{•nt of lower ft-rs 1h'-· Authc,ruy shlll rt:rund the balance 10 Ille .ipplu:anl \\;Ihm a reasonabh:-. p.:riod of 1imt 1hrvugh ;i crossed chtque in fovour uf,hc applicant 7 The ;ippli\;1'fivn "''-HnpJ1.tc in .,II 1c~pt:,1s ,1longw11h Ai:~oum Puyei.· lJNitnmJ l)ral{ shourd be forv.41rJtd b}' the :ipplit::mr to rhc fn!lowing add:'l'ss· The l11:,ur.1J1~e R.:gulntury .ind Dl'Vl'll)pment AULhurH) Gmt: No. J, First Flour. J~~\'1111 I r11 .1 Bld~•- 5, Parliament S11,-,,1. New f),•ll11-I !O 00 I R No ;\Cknowledgcm"nt t"I 1l1i'-l npplu:~11,uu will be sc111 If one- is req\.111 .. .-d 1hc apphcarion should be- sent by r~gisu~r1.:d post (ackm,wlcdg_cme111 1.h.1t•) '> An affidavit cu1 nnn-juJkial -=tamr l"ll'l"r i~ 1cquircJ 1,.1 be furnisht."J for li1:sh licc11cc in the fonn ofa <lcclnrat1011 ,lS i:ont~lirn:<l i..; s.~o. '{ ('!f the appllc-orillfHl fom1 t"" 'ITT111fil ~ : = INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY FORM - IRDA -3A - AF (See SI.No.4 of Form-lRDA-3-AF) To be lillcd in by every director/ partner ·or the Company/ Firm I. Name 2. Da1c Of Oinl1 3. Current Licence No. & 1¼1e of Expiry 4. Nationality 5. Qualifica1ion (of the diructor/ partner <>f Company/ Firm ) a) Academic/profossional Passpon size Photo (3+1) b) Insurance -·····------······--·-··--- c) Training ancnded (Nature - dur~tion) •- ··-·-····--············-·-·-··--- 6. Communication Phone Office Phone Res. Fax Pa~er Mobik E-Mail t-------+-------,,------+~~----+----------+--'-- 7 Date of Bini, of the director/ partne, ,,f the Company/ f irm 51 S. Practical Training Details of 1he director/ panncr of 1he Company/ Finn. (Please enclose 1he certificate of 1rafoing obtained from the surveyori survey firm) Nam1t of Departments Ciitegory Period of 1111ining Name of ,'\ ri::a!. Result Su1veyorl Allocated 10 1he A\'-'Mded to undergono person(s} unda l,;QVL->.Ceci S.l.irvey Firm Survc)or/ lhe 'i-l;rveyor.' (Please mention whom 1raining Sur•,ev Firm - Survey Firm d3tos) undenakeu 9. Experience: .1) Whether the direc1or/ parlncr or the Company/ Finn was employed w11h nny insurance com pony (Ir so. give dctaii.s)· t,) Job l::xp<rience of the director/ partner of the Company/ Firm (if applicable} in previous cmploymcnl other lha.11 iu~urance surveyor. lfany: _ c) Details of other business/ cmpl->) mcnt: ______ _ 11 · ·· ··· · ··~ ·· · · · · · · · ··~ · •· ··· - · - .. solcnmly declare and cQnfirm I hat the partkulnrs given above are true 10 the best of my knowledge and belief, Signature Name: Date I • 52 nm GAZETTE OF INDLA. E)CfRAORDINARY INSURANCF. REGULATORY ANO DEVELOPMENT AUTHORITY FORM - IRDA-4-LF (See Regulation 4 (3)1 NOT TRI\NSFERABLE No. INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY LICENCE NO ......................... . LICENCE TO ACT AS A SURVE:YOR AND LOSS ASSESSOR UNDER T IIL INSURANCE ACT, 1938 .................................................. S1ree1. .................... Towu/ fP,\RT Ill-SEC. 4] Address: House . ....... PinCt.)dc.. . ..... having paid the sp,ecifie<l foe and 1,.,,,..mg mudc lhc ne<:c~,;ary declarntion 1~ _! hereby authorised undc, Section 64-UM of the Insurance A<t. 1938 to ac1 a.~ surveyor ,>nd loss osscl\.'lor for fiw L>1s1J1c1 State ye arr. from ..... , .. Name ... . .. . . .............. are alloc"lcd 1he following dep;Jrlmems and ca1cg.orv i-::D:,:•=i,,._· --+":..:' '='" ---i-.::!Vc:.lr:..:'::..' ..::C:.::a::..r.._o4 ..:A.:.:1c.:.r.:.:n..:~.::I u:::l::..l _i...::Ee:n...,,.:......_-+-'/l-'-'1"-o'-'to"r _ _ +il-:.:.1:..:is::;~:.:.-- -+..::Lc,Oc:P:......_--1 C'i\[l'U(U \. ... 20 ..... Szal of lol Fi1 m:Cvittp,ur, D•:::.1g:mucd Pl:r~nn lnsunmre Regulatory Jnd Dtveluµtncnt Author,ri. I. .> (Sec No1es on 1he rcvor><') Note< If ii is dc~ln.: 1i1 r\~nt'\\ chis fi-.:..:11\-i.: for ,¼ huthcr ri:-riud !he: prore<lure stated m the- Rc,g,ula11ons shr11t be. followed. JuJ ,1. Jpphc;.1rton le,, rc1t,'\',J, :,houlJ reJch 1hc Amho11l\ 3ileast thmy Jays before the lict·noe cxp1re.s rhis lice,1Lt.: JJl 1hll 1t.:-::. tht: ltct:acL· l1uldcr to ,Kl ,\~ a '\II: \C\•Jr i:Hh.l i{'Ss .:!-ses~or for ;my registered insurer and lh..:rcforc. no id::n1tf..,,u1~ mark or noh;' <,f .iny dc-.,_,nrtll,11 b)· w!11C'h the i<lcr•nity of an insurer m1gh1 bL· csr'.lbhshcd ... h~: .dJ !l .. pl!i(;<.:J on the !1t.l.'1h.'.c- No correction m th~ licence sh.ill be .. ,alid 1111le~, inniuled hy 1ht- Designated Person of1tie Au1hority • C From : INSURANCE REGULATORY ANO DEVELOPMENT AUTHORITY FORM· IRDA - 5 - AF !See Rcgulalio11 7 (1)1 APPLICATION FOR RENIEWALOF A LICENCE TO ACT AS SURVEYOR ANO LOSS ASSESSOR 51 Sh.!Smt/Kumari Passport size J'ho10 Name of Surveyor/Loss Assessor (in Hindi & English) (3 I I) l'u II Address (m Hindi & English) workmg as so lc·-pr◊piictor of To The Insurance Regula1or, Arnhority Gak No. 3. Firs! floor, Jeevan Tllra Bldg. 5. Parliamco1 S1rec1, New Dcll11• I IO 001. Tel. 3364711. Licence No. •-··- - ···-···- ·······-··•Da1c or EKpil)' •······-········-··········---···· Depts. 1\ ll0~1ed _ _____ Ca1cgo,y _____ Jl)("ard No _ _ __ _ Dear S1r. I request 1ha1 the <.1bovc licence may be renewed fo1 a fun her r,:rio~ 01· lhc years. 2 I enclosed De,naud Dmft No. •-··---·······-··Da1<d •···············- ···-····· on ··---·····-········-········ ...... _ ... 5i,owing !he pa) men! of k,· 3 I declare 1ha1 since lhe dai~ of my las! Jpplica1ion for hccncs (,11'liJa, 11 "" non JuJ,c,aJ p,1pe1 - dul, no1oriscd), (i) I have noL bc1.•n round cu he unsound mind by o Com1 ul LlHnpe~em .1urbdict1011 (ii) I have not ocen found guilty of criminal mbappmp, "''"" or cr11J11tlill brcnch nf 1ru,1 or chea1m!\ or forgery or <in ~beu~cnt of or attCJnpt to cnmnrn a11; ... ud1 ufl'i:m:e by •1 Co1:n ot tompi:tcnt jurisdiction. (iii) I have noc been found guil1y of or 10 have k,w" mltl) p;1111c,pn1eJ 111 ur co111med Ol .m) frau.d:dishones1y or m..ide any misrcprescr.tation <tgalm,t i.lJl 111Miri.:r or dO msurcd m the c.:ours:.: of any judicial proceeding rela1ing, to a policy of i1hu1<111cc or th~ wmd,ng lip ut any ln\es.ug.:iuou or the amurs of an insurer. (iv) My liccncl! has 1101 been cancelled at any 11mc b) the Controfkr of l11'iurnncc.' insurance Regulal<rry and Devclopme111 Aull1ori1y (v) I declare that I continu-: to hold the qualifica1io11 on the b:1i;b ot' \\ hich Ill) fu:cn,~ ment1onl!d above was issued. (vi) An undertaking on performance report showing $Urve-) wort.. dune IJy m~ during llu: last 5 ye:irs of the validity period indi'cating total rnumber ofsurv~y work .• md amounl mvolv~d m e;,ch cat<:gory of cases, year .. wise and compan)•-wisc is enclosed (vii) In addirion 10 surveyor's work, I am also engaged on t>thL"r occupations. the dc1ails of wt11ch are given bdow: Or I :1111 not ~11gagcd i1l any other occupal ion. (viii) I have 1101 violated the code of conducl of 1he Authoril) (ix) I have 1101 con1ravened any of tl1e provisions of 1he IRDA 1\c1. 1999, lnsur~ncc Acl, 1938. Rules and Reg.ulations made thereunder including any order or d1rcc1ions issued by 1he Au1hority or :rny of i1s designated persons: J Hl GAZElT!cOF INUTI\ EXTR.AORDlN1\RY {x} r have not nrndt a slah:m..-nt Y.h1ch ls folse in 1m-Ht!nal p:111icu!ars with n:gnrd to lrl} ~ligibdit) fh1 the hn:nc(" or renewal lh·n:ofN i11 ml) ofche ac!rvici~ rrans.tcl'..•d by me or the 1nattcrs: co,met.ted thrrcwith .is a Sur"l.!'Y('r ~nd Lus~ A'.)..'iessor. txO I h:wc neither ,n1racted rhc: lli.sqnaJiftcation provisions 1.:tcrn.·d to in lh\' ltl.sumncl' Act, 1938 nor viohm:~! lhc LOde of cunduc1, ~nd ~-'ii) 1 hnvc rertt.1m,,:d Llk' Juti::s & respons1b1h11cs a., a profo!_,,,:sH111.iL 1,i,i I J ~n,lo,c 4 p,,s;pon size pho1ogrnphs. J. Whc1hc1 the Jpplic-,1n1 hd.S been In prattice as ~l Survi:}Oi' and Loss A:s .. c.;.~vr -on thi..- 3 , ~, Mav. 1970 (say Yes or Nu) If a1,~w~r 1, lr. nff:rmative ,·md rfu: applicant doe:-. no« posw~s ;lny ,J' th1. i.Jt1dhlic,11ion5 ~talcd in lniutance J\....t, l9J~. ,HIJ rnlc;; .ind rc-gul,.tti,>11, m:uL: 1hcreumh:: rh.: appl,cam !l'U;1il r1uk1; a dcd:ua11ott j:!J given in Ll1c lnsur..tnCL' Rule~. 1939 and duly o;w111 n h-eton: :1 Mag,scritte or a Nc,1ar} (>11hJrc ; al,;o dccl.ir-.· thiJ! !ht" fac,~ '>tiHc't..i hcn:111 ur-: 1ruc 5 111 tus-.: liceHt~e ic. ~ubmltted .11ier c.'.piry upti.; J nt.1;d:1)um pt.'1 10d nl ~.:.; mnmhs, the lia..:~1,cc k \! will be: Rs.200/- w,th a pe11aJty ~,r R>.750/. (along with phrnu. "PY of quallti,.11io11 dul) a11cs1cd by notar) See Serial No. 4 of the appl1CJW..tn fll••t.:s> Your> lilithfull), Sig.nature ot the Applicanl Datcd•-··-·-········- Chcck L1s1: I{ I J D,D in fa\l,'Hff t'f 1n~urance Regulawry ;,1nd Devdopmen1 Authorn;,,. pa~.,ble :u ~ew Delhi (2) Cop\' nfp1t"V:•1us !k~ncc. (3) 'Jua!i1k~1iM copy (4) ,\fJidavit \5 > Vlc,rk performancr: 1cpon (6) Sclr-addr~s'i.cd en.,...c:op si1~ ..s :5·· x I()" w1tn R~. I 7/, p(>~.t:'1ge stamp~ f7) ~1 no 's pilsspmt Sib! phnt0gr~ph~ I ·•rn Lil-= 4 l The attc,uion of the app!ica111 is dro\\n to Sectfon 102 of1he lnsuru11ce Act 1938. w!uch pro\'idcs that whuc,cr in ..1ny document rt:qmred for the purpose of .any of the provl'Slon:) or Lhc ,-\ct.. rule~ ur reg_ulatJous. m1.1di: 1haeunuer fails to furnish the sanie. shall be li3blc to a pen31t) nol excccdin]!. Rs 5 lakh< for each ,uch ra,:u,c and punishable wi1h fine. 2. 1 hm nrimc and the Lirenct Number g1vcn ,n the a.ppiication should be i<li:ntic.al wi1h 1h..:~c. ;--ho\\.1 in the Lt<'cn..:i: held. 1r Lhere i-; "") !i.ubs.cqoem change- m the nam~. ,he n:.il">OH~ fur th< "ame- stwul:i l"-' ~tc1h.:J !iirn1'::bi11g documentary evidence for the s.1me. ,.'\ny corre:1;.tion ur al!cration n~n<lc m :m~wer to c.hc questions in the :\pplication ,;houlJ lw ini11al1ed b7· the applicant. 4, The applicltion shoulJ reach th.; Authority .a1leust thirty days befo1~ \he c>.pir) of the h,.;;~nn:. ' A fo~ of Rs. 200.'~ should be piid hy means of Account Payee DcmJnd Draft in favcl11r nf lnsur:inte Re.{!.ulatory and D:.!veluprnent i\U1hority. New Delhi drawn on Indian (JV(bt:El.) Bn.nk. Parl:amc111 ';tr~c-l Ur.m::h~ New Delhi. 6. If the fee is nH1de for a category of ~urvcyor and loss ;tsse~sor hc-\!nc~ ,,. h1ch mvol '-'•:.; p:t)•mcnt of hi~her sum of money and 1he Authonty grMI< a 1,cence whO$i! category involves paymer.1 oi' lower Jee~ 1he Author:iy shall rd'und 1he balance 10 the applirnn1 w11hin a reasonable period of time 1l11011gh" .rc,,;sed cheque in (avour of!he opplican1. 7 The appli..::3lh)Jl compl~tc in aH re~oi:ct a1<\ng with lwnk draft n11d thr c,·rtiflcatcs att;.•stc<l Uy -i f'>.1agismnc or a Nota,y P,,blic should be forwarded by 1he arpllc:m110 the fo!lowingnddress by Regisme<l "nst; Th,~ 1 i.suran ... c R1;c:.ulat0l) ,11~\! De, c,i ,p111-; ,~: Au1 h: ') it.; untt: 1-..:u 3. F\1:it floor. h,'i::-..a:i l ;m~ Bl1:i,.:frw. 5, Par1nmcnt Street. New l.•elh1• 1111001 Tel. No 3'~647 l 1. Cuquir; B.twccn 1500 hrs. to 1600 hrs. S. Payment in Cash or by ~tune; Order. Cheque. P,,;tol 0rrler, Po~1.1gc "' lns•m,"ce Stamp is nol accepted and will be ll.'.iumr.d ul apoii,;-.t1r.t > 1:.c~t. ? No ,r.kno\\•a.lgcmc111 of 1l11s applicm,on will be ,en:. If 011c h rcquire,J lhe avplica1io11 ,hould be ,cn1 by resi,;tc.r'°d ~,~t (ackno·1. l<'dµ.:me!ll duel IO An affidtwh d:.1Jy notorisi:d on non ➔1ud1c1al stanrp p:iper is ri::quired lO bl! furruc.hed fur l'eni:,val or liccnc:s m th1t form nf '1 ded,1.r;it!on as t:01H,1::h,--d agrua~I S N('I tl t .i 1,1f1h1.: 11;:rlicatio,, form. 56 THE GAZETTE OF INDIA . EXTRAORDINARY lNSURANCE REGULATORY AND DEVELOPMENT AUTHORITY FORM· IRDA-6-AF !Se• Regulation 7(1)1 [PART 111-Si;c. ~] APPLICATION FROM A FIRM OR, CO!YIPANY FOR RE}\/EWALOF A LICENCE TO ACT AS A SURVEYOR AND LOSS ASSESSOR From- Name of the Applicant .................. .. ....................................... ...................... . (In Block Letters in Hindi & English) Full Address .................................................. ~··· .. ············· ...................... .. To .. , , ............. , ....... , ... " ................ ,., .. ················ .. , ............ ....... . (In Block Leners in Hindi & English) Insurance Regulatory and Development Authority Gate No 3. First Floor. Je.evan Tnra Bldg. 5, Parliament Street, Ne" Dclhl•l 10 001 Tel. 3364711 , Licence No . .......... Department Alloca,ed ... .................. Category ................... . I l.l Card No .................. Dttte of E,riry ........... . Dear Su, It i, requested th~r the above licence may be renewed for a fonher period of live years f(,r th~ fol:owing classe~ <>f lllSUrJm: c- Fire Mrn Car •o Mrn Hull Ea . Motor Misc. LOP ~ I he receipt No . ............... dated ........... from ...... ... ... showing payment of fees of Rupees __ Is enclosed 3 It is hereby declared chat- \ I) no direc,or/ partner of our Company/ Firm has been found to be of unsound mind by a Court o f CC\mpetem Jurh<l1ction; / ,i) no director/ panncr of our Company/ Firm has been found guilty of criminal misappropriation or cnminal brcJch of 1rus1, or cheating or forgery, or nn abdmcn1 of or attempt to commit any .)W:h olfo,ce by a Coun of competent jurisdiction; \ iii) no d1r«;tor/ partner of our Company/ Firm has been found guilty ofor ,o have knowingly parucipatcd in or connived at any fraud, dishonesty or ntisreprc-sentJtion against an insurer or an Insured in 1he course of 11ny Judicial ptoceedings reJ:uing to any polic.)· of insorance or tht winding up of an Insurance cumpan> or in the course of an invi:!'srigation of the ttrf&irs of an insurers; and crv) no director/ partner ofour Company/ Firm is a minor. (v) no direcwrl punner of our Company/ Firm shall violmc rhe code of conduct specified b)' the rqt,ulmmns made by the Authori1y. (vi ► all dircctor(s)I panne,·(s) of our Company/ Firm possess the requisne qualificmions and prawcal tr,mung ns specified by the regulations made b) 1hc Authority. (, 11) all dircct<>r(s)I panner(s) of our Company/ Firm have passed such examination as spcciiicd h} !he n..·~ula1:ons made by the Arnhority . ..i Jc ,,.i ded~,red thal cath one of the partners/ Directors of che firm who was a partner/ Dircc1or when tht abo\ t" mi:n 1ic.ml!d htencc was issued and who 1s now a pann,er/ Direccor continues 10 satisfy the rL-.quirements ofclau~c \I>) ,,1 suh.see1ion ( I) of Section 64•UM of the Act. .. 57 5. It is also declared 1ha1 rhe parriculars given below arc 1me. 6 The names of all the director(s)/ pa11ncr(s). wilh their addresses, are given below. stating in each case lhe dace of birth and whether lhe parrm:r or Direc1or or employee claims 10:- (a) have been in practice as a surveyor/ (a), ............................................. . loss assessor on 1he 26'' October. 1968. or ......................................... ... . (b) hold a degree ofa recognised (b) ..•..............................•............ uni versi1y in any brunch of engineering, or .................. ........................... . (c) be a fellow or associate member oflhc (c) ..•.•..•.... , ........ •.............••........ lns1itu1e of Chartered Accountants of India ... .................. ..................... .. .. or lns1itute ofCos1 and Works A~count.ants ...... ........................... ............. . of India, or (cl) possess actuari~I qualifications or holds a degree or diploma of any Indian Un,versily or Institute in relation to insurance, or (e} hold a diploma in insurance gramed or recognized by the Govemmenr. or (I) possess any of the technical qualifications mentioned in Rule 56-A. ..... ············ .................... ~ ....... . (d) ..•.............. ..... ,. .................... . .............................................. •••••••• • •••••••"•"••• • • • • •oo .,,o,••"•• O•oO (e} .................. ·••··········· ........... .. ... ......................................... (I) .............. .......... ...................... . . .................................... ~···--.. . (N.13 In 1he case of C11ch of the director/ panner who was not a panner/ Director on the date of last application for licence:- i) il) where he claims to come under i1em (a) above, and is no1 eligible to come under nny of the items (b) to (I) above, a dcclamtron as given in I.he Insurance Rules. 1939 and sworn tie fore a Magistrale or a Notary Public should be forwarded with this form; and where the claims 10 come under any one of1he items (b) to (I) sbove, either !he original diplomas/ ceniricates with one o(the attested copy each, or copies of Lltc original diplomas/ certificates duly anested by a Magis!rate or Notary Public should be enclosed. Where original diplomas/ certificaies are senl, they will be relumed after perusal, bul no nesponsibili1y can be accepted for loss or damage of such originals). 7. The individual details of all new director/ partner in tl1e Company/ Firm be enclosed as per FORM-IR.DA-6A- AF annched. Name of place .......••... ... ..... Dated rhe ............... ...... . Yours faithfully Signature of applicant Designation Niime of Firm/company ................... . Seal oflhe Company/ Firm I 58 THE GAZETTE OF INDIA . EX'ffiAORDINARY (Sec Notes 011 the reverse) CHECK LIST Please ensure: l) Draft in favour of Insurance Regulatory and Development Authority, payable al New Delhi. 2) Copy of previous licence. 3) Degree/ Diploma ancsted by Notary/ Magis1rate only for new directors/ partners of the company/ firm. 4) Affidavlc duly nocarised against S.No. 3 of the application form is a must. 5) Self addressed envelop of 4.5" x JO" with Rs.17/- postage srnmps. 6) Work Performance repon 7) Please enclose FORM-JRDA-6A-Af complete in all respect along with anested photocopies or the documents in respecc of all new direccor/ partners/ emolovces oflhe comoanv/ firm. Notes I. The auention of the applicant is drawn ro Section 102 of the Insurance Act 1938, which provides chat whoever in any documenl required for the purpose of any of the provisions of che Act. rules and regulations made thereunder, foils to furnish the same, shall be liable to a penalty not exceeding Rs 5 lakhs for each such failure and punishahle with flne. 2. The name and the licence number given in the applica,ion s'1,ould be identical with those shown in the licence held. If there is any subsequent change in the name, the reason for che same should be stated furnishing documentary evidence for 1he same. · 3. Any corre.:cion or alteracion made in the application should be initialled by the applican1. 4. The applicmion should reach the Aulhority alleast thirty days before the expi,y ofche licence. 5. A fee of Rs. 200/- should be paid by means of Account Payee Demand Draft in favour of Insurance Regulatory and Development Authority, New Delhi drawn on Indian Overseas Bank, Parliament Street Branch, New Delhi. 6. Payment in Cash or by Money Order, Cheque, Postal Order, Postage or Insurance Stamp is not accep1ed and will he returned at applieam 's cost. 7. If the fee is made for a category of surveyor and loss assessor I iee11ec which involves payment or higher sum or money and the Authority grants a licence whose cacegory involves payment of lower fees the Authority shall refund the balance to the applicant within a reasonable period of lime 1hro11gh a crossed cheque in favour of the applicant. 8. The application complete in all respects alongwith crossed Demand Draft should be fo1warded by the applican1 10 the following address: The Insurance Regulacory and Development Authority Gate No. 3, First Floor. Jeevtm Tara Bldg. 5, Parliament Screet, New Delhi-110 001. 9, No acknowledgement of this application will be sent. If one is required the applicacion should be sent by registered post (acknowledgement due). 10. An affidavit on non-judicial scamp paper is required to be furnished for ire~h licence In the form ofa declaration as contained is S.No. 3 of the applica1ion form. t I INSURANCE REC.ULA TORY AND DEVELOPMENT Al'TIIORITY FORM - lROA-6A-Af' (Sec sl.No. 7of form-lRDA-6-AF) To be filled hy t>Cry tlirector/ partnet" of the Company/ Firm 2. Da1e OrBirth J. Cu1rom Lie<n'1, No & 0Jtc ,}f C ,pir; :. Qu.J111ii:21;.~n ruf 1h\! new partners of the firm.' new dirtctors ol'thc cumpauy) Passpon size Photo (3, I) a) A,.,Jcr.,1l',.pt fo%ionaJ -h·•··-··········-······---·----···- 1.-, In! 11ran1." ..... ·-······-····-·-·-·--- · ·----·-·-·- ,._ 1 l r ii. 11:_: Jfll•nded I N.1t11re - dur.11ion) ............. ---------··--·-·-··- 59 i 1'•.,1:1,al r1. .. ning Dc,atls vf ne:, ~,1.111crs uf Ille time n~v. dirce1urs t)f the co,•1p,1ny. !Pi~illc cndosc 111~ C1oJP ,tk .. 1•rr.:1'lir!:, ,1t"'.!!.l:t::J fr._.,11 •!i •Jrvc::,ur/ s~•r\e, t~r:i 1'1,111e nt <:UJ'\t ,, I I • I !.'l:W\~)' 1-i~·n f1t.p.,1111Wlh> I .\ll.1c:,h;:1; M ,n~ SU(\•~•ynr, i.::ur,,t.'\ f ,ll -1-- I ·---__ .,_ __ \) l ,pen~1~ ... ,:· ( .ilr g, ·I: - 1 P,·1 m,1 A\\ 'l" '.i:J ~--· I :1·:1i1HI~ tm: '1 · •"•'l•I'' un,it:rr,i"mc s.,1rvt." 1'1 11 I t!•:t:i_.,i: ::l~f1t1on I J.,1,:sl I vi pcrso11(,) um.1\!r whom lminin~ un<lc11ah·n iJ j/h:?tht:r ;\ny of ht> new patneN o( Thc f1rmi ne-\1,• dircciO() of the compan) ,\n.::i emplo~i:d wiLh an} m:,urJn..::c r.•-imr,~ny {Jf,o. _gl\'C detail':!) h) J,,h [ '.q)enc11cc N. ncw ,;artnt·rs f, ~ 1h1.. fo n. Tit: \\ d1rcctf>rs cf the comp,m) (1f applicable) in pr1.•v1ou:, tmr!•;:·1 :-;:nt ,nl--~r th:rn m~uran"C ::.urH·yu1. f 1ny _ ~, t;1.·,. I· of ,1111 .. ·, husim:ss' c1nµi0: 111~· • I. mv kno,, ledgt· rind h1:hcL 5ignature J.7.7.4 Ct:1000-9 t I (,() lllE ti,\ZETTf.:. OF i\iDlA LXTRAOROl',ARY If ~ JII -S ~I INSlllUI\Cf 1<£l;tlL,\TOR\' A'-U 1)1-:\ l:.LCW\lf'l;T .•IL TIIOHJT\' IOl<M - l!ill.\ - ~ I.I· (Set ltcgul,llio11 ·(:I) I.JC I· '-Cl< '-0 ..................... . RF"-1 II !IL or I Ill '\l L Io \CT /I', A SUI( VL Y(II( \\d.J LO<;S •\SSF~~OR L \DLII rnr l'<SI l\,\NI "EAU llJ '~ Mr Mrs Miss ;\JU!l.'S.S i'n.,sporc size Photo • wprf.. mg ;l~ ~ok proprietor ol .. ., , .... .. •. ..... , ...• , . .. .. havmg p.11d the ,;,n~-:ili..:d ic..: a11d hn,..ing 111Jd1.: 111i; n~c~ss.u; dccli..1.i:io11. hi~• 11.:r Licence No, .....•.... .. da1~d H• rict ns a surveyor 21:d foss asscss.o b ! 11.:n:~y nmc,, ::J uplo , • , ...•. .... day of }U Numt' ...!!£!,ts Frre C:t1egorL .. L.. __ _ :'-11:w O<.·lhi d~itc.:d tht" . . 20 Sigm11urt'. 01 lhc Ucl'ncc 11ohler .. • (Str,~1.: (1\1' it not requireUl Ot::,1gn.:ltt>d P'l..'rsnn rn.).~ll'llllCt.' Re~ot,Hor1· und Dt:\1.:lopm,,:nt Authuri1) (See No1es on the reverse) If Ir !l. ,.k~lrc.-ct to rt-new t!1l.-.. licl.!1:,. .: ll>r j iurthc:- p~r1od thC' prnc<.:dwc s.lah:J in the R.1.:gulation'.) ;)il;lll LH: fr•llm,•I.',,, .1:1\1 ;m .1ppht:. .. 1cinn ti,, H'.111.:wal -.hould re11ch the A11th,n1t) • .11fL·.,1it 1111ny tfays befor~ 1hc hcencc c:-.rwi:~ r'hh iicctlCl: .1mhorj~\:S th,~ hccncc holt..kr to uc:1 ris n survtyor and loss :issc~sor lbr any rcgis1cred in\Utl'I aml lhcr,:for"· 110 1dcnt1fyi1:~ mJrk <11 11otc of a,,~ dl!scnpt1on by wh,~h th1.: ictenlil) of un in~urer mighl bl'. c,tabli~hcd should be placc<l on tile hcl'llcc. N0 C(II r\..·Ction in th is l 11;¢.JlC<' '" i 11 be val ,cJ uni cs." 111iuallcd by 1he Dc~1gr1ah:J Person of lhC ,\ullh>ril) INSURANCE REGULATORY ANT> DEVELOPMENT AUTHORITY NOT TRANSFERABLE FORM-IRDA-8-LF !See Regulalion 7(2)1 LICENCE NO ........................ .. RENEWAL OF LICENCE TO ACT AS A SURVEYOR/ LOSS ASSESSOR UNDER TJ!E INSURANCE ACT, 1938 Nnn1< ............... .................... .. .......... M . ... ............. . .. . . ... . ... ........... .... . . . 61 Address..... ..... .. ................................. .................... .......... .................... .. . .... .... . .... . .... ... ........ . ... ........ ........ .......... ...... ......... ... having paid the specified lee a11d having made the necessary doclarauon is hereby authorised under Section 64-UM of the Insurance Act, 1938 10 net as surveyor/ loss assessor for five years from ... : ............. ..... ................................. .. arc allocated the following dcpanmon1; and ca1egory: Fire Mtn Cn o Mm Hull En . Motor Misc. LOP Nev. Delhi. dated u,c ........... 20 .... . Seal of the r-iriniCompany Designaled PcrSon Insurance Regulatory and Development A111horily (Sec Not-es on the reverse) Notes If ,t is desired to renew 1his licence for a funher period, the procedure stated in the Regulations shall be followed, and an application for renewal should reach the Authority atleasl thiny days before 1he licence t:~ptrC~ 1 ·1 ha, llce11ce authorises the licence hokier 10 act as a surveyor and loss assessor for any registered insurer 3Jld tlioretore. no 1den1ifylng mark or note of an)· Jescrip11on hy which the identity of an insurer might be esiabhshed should be placed on 1he lkence ~ N" correwon i11 this licence will be valid unless Initialed by the Designated Person of tho Authority !!!!! I 62 To 11-lE GAZETTE OF IND!A EXTRAORDINARY INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY FORM • !RDA - 9 fSee Rei:uJation 10(1)1 APPLICATION FOR 0UPLICA TE LICENCE Insurance Regulatory and Development Authority Gau, No. 3, Fi,st floor, Jeevan Tara Bidg. 5, Pad!Jment Street, New Delhi-I JO 001. Toi 3~6471 I 0e,,r Sir, I tc~rot in mform you dr.n m)'·1 our licence no. _ _ _ expiry tlat<. _ __ h;;i~ been I Josi .., dcs!r•_\ved 3 lllUlli3lt.' J by rh~ folknving ·m;umst~nces --------- -- --- ... ---- [P,urr lll-SRc, 4] - - - ---- [I We . therefore rcquc~I 1hc Authorny to k111J1, JSSue a duplicate ikence in light of the circums1a110,, explained ahu,·-¢. f. "' .. my kno,"lcctg,~ :md 1.&.• 1,c ( Signature I INSU~AN<'F. REClll \TORY ANO DEVEl.~l'Ml'N''. \I.ITHORJT\ NOT 1'RANSFERABLE FOllM- lk0A - IU- LF 11:>c. R~~ulatiou IO(JJl UCl:.NCF NO, ...................... .. Ill 'l'l.lCATf. Ll("f.NCT N:im.: ·\<lJri:s:i H;,u,;"· No Succl io•._.n: D1s1r1ct ~l.1!1..· rin\'.'o~ h,:vim!. rk1h: ft.!io Fi\·~ ,ml\ .,11J l1!l\'U 3 !1iJJt: th~ h~~~S5tlrw' .,k, l,l1"JUVH of hJ\'IO\.! lo'i;f/ dc.stroycd1 :i,ut1J:itl'<l 1h· llc,·1·:.:t , ... h::1•.:b~ 1ud 1nriv:d under S· 1in11 (l~ ·I 1~1 ~lf the hbUIJn\:'.c .l\~t. J'HlS 'l i.;ommu'-' lo a,:l as smv..:yc.,r and It,.,, as:><..'".-'.WI fl•f 1h: b;ilJncc pcnod 1111 ::q1ir~ .,f lill lh1,'itl~ NcH Ut::HH. \iul1..J lilt ..... , ••• , :D .... S1!,:nu1urc ot chc L1<'<1lC<: holder . , UR S,•..11 ,1t lh\! I· nm '· iJn1~qny : 1. ·-.i~J1;..teJ Per ll!I l11s1•1;\,ll..t.: R1.L•.1,;.,lof) JO'i 1),-,,-., •fHl~•~n· ,\uth,,rit} .; if' 1t ,:;. desireo ro renew thy .,c.:-rn.:c h>r a fu11h~r pcnod, rtie vr, .:Jtm: ~1111.'d 111 llh 1h-;,tilawm:- ,h JU l•. folJowed. and ::m applif.:lHPH for n!i11;v...1I shc.m..ld m.ich tl11 Autl11111ty :lllt'U!-i thiny d.Jy"" h•:-fo,._.. 1h1.· !u.-1.•n-.;1,; txpir..:-s 5 1 his licence -iu1honses 1h•; hci.:nc~. hol<lt.!r ro acf as a ~\1r,·,:,·<.1r ,ind k,-:;, .,,;-.1.::--~c,r tor ony n:r1sh:r..:d 111:,m't'r c111J therefore. no identifyin.g. m;irk or note of nny tk~cnption by ,., luch tht: 1Jcntiry of .1.0 in.surer might he cscabllshed shou Id be placed on the liocnce. o No <:orreclion 111111is licence will be ,,ahd unless m1t1.alc<l b;, !he lJt:!)1gnu1~~d Pc..·rMm ot th~ t\u1hnnty l I rHE GAZl:ITE OF INDlA. EXTRAORDINARY fOR,',IAT OF IDENTITY CAim FRONT ll'<SURANCE RE<.;ULATORY ANO DEVELOPMENT AUTHORITY Gate No. 3, First floor, Jccrnn Taro Bldg., 5, Parliamtnl S1rcet, Ne" Delhi - 110 001. Ph. No. 336471 I SURVEYOR AND LOSS ASSESSOR IOF'iTITY CARD l'iame: -:-:-----------,----- Address: Hou>t' No. _Street. _ _ _ _ D1stttct ____ Town.' Cit)' _____ _ $me ______ Pincock _____ _ Survcror Licence No.: ___ Vn!id Till: ____ _ Dep:1rtmen1s Allocated & Cate orv: I Fire Mm Car o :',1rn !lull En ,. Mnlor Mi,c. LOP Oesii:natcd J'crson: _____ _ f'lca,:j.e surren<ler this curd on expiry/ suspension/ canci:11::ul\.ln. 1.0. No.: __ _ Passpon Photo Signa1ure of the Licence Holder ! The Licence !!older 111»s1 lnfon11 the Au1hority immedi.1tely if this c;,rd is los1 or stolen. 3. 1'111, card I, 1h•, property c•ftho Aulhvrity ond i~ not transferable. 4. It this card is found please return Ill the Insurance Regulatory and Development Authority's Oflicc 5 Warning. Misuse of this card i> an offence. I ['ll'l LU-= 4] FORMAT OF IDENTITY CARO FRONT INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY Gate No. 3, Firsl Floor, Jeevan Tara Bldg., 5, Parliament Street, New Deihl- J 10 001. Ph. No. 3364711 SURVEYOR/ LOSS ASSESSOR IDENTITY CARD Name: _________________ _ Regd. Addres$: House No. ____ ,Street ____ _ District _____ Town/ City _____ _ Stat< ______ J>incodc ______ _ Ftrm/ Company Licence No.: ___ Valid Till: __ _ De anments Allocated & Cate or·: Motor Misc. LOP Designated Person: I. Please surrender this cnrd on expiry/ suspension/ cnnccllation. 1.D.No.: __ _ Scali Stamp of the Firm/ Company SeaVSIJlmp or the Firm/ Company 2. The Firm/ Company must inform the ,\uthonty immediate I} ir this card I~ losi or stolen 3. This ca;d is the property of lhe i\u1honty nnd 1s not transforJbk. 65 4. lf this card 1s found please rernm to found please return 10 the lnsuranco Regul~tory and De,elo;,ment Authority's Office. 5. Warning: Misuse of this cJrd 1s an offence. s. Name No and address of the Insured INSURANCE REGULATORY AND Df.VELOPMENT AUTHORITY Nsmc & Address of the tnsurer FORM- IRDA- II (See Regulation 15(11)1 FOl1MAT FOR KEEPING RECOR05 FOR 3 YEARS Policy Dept in Dale of Date of Dote of No. which nllocation sun1ey/ submi')sion the of survey in.;pt1ct1on of survey claim work report foils . Amounl of Cl:Hm assessed No1e: The survey repons, phntographs. ¢!~ as mentioned in rcgula1io11s 15( 11 ) shall be ~ept ~epurowly. Survey ~·cc I Dttalls (Arnn!/ di. of pnynicnl) --- r I 66 TIIE GAZETrE OF INDIA E:\'TRAOPJJ1NARY INSURANCE RF.GULATORV ANr, uEVELOi·MENT AUTHORITY FORM - 11<.IJA -12 jSee Rcgul,tio !O(b)j FORMAT FOR ANNUAL SUBMISSION OF n•:TURN TO T/1::: AUTJIOR!n· I. Name 2. Currcnl Licence No. & Dare of E.,piry ) Qualifications acquirtd in the r a,r one year • .. \ca'1i!mic/Profc:tslon:tl • ln'>urancr • l ram111g Attended iNa.u,c nnd durat;on) ,1 No or surveys: don{> in bst fin:i·tcio:I ye;,r Jnd the narn: cf 1 1:.u1i:t:-i· 20 _.20_ ~ (Juanrum -:iflo~s,·s assc.;s:,d 111 bst lin~r~1Ji vcat lO_ 20_ F•ri' '"..'o J Mm. No. Mm. ., Fng.g 1'110 Cargo . !lull ,-..... ~ I {J >I lac ,JO >25 L,1..:> lac~ lacs - -- l 0 l0 25.000, .2 .')· 50,(i(ii) I Lacs I lac 10 -2. ~ la.:s lacs - I Nn - I I ~o.--· -rc l"'l 0- 0-2 5 L3..: 25.000 l;cs 50,000 I I . - - I l <)t;,.f .L__ I -- - -- 6 :i) fu..,0111,• ij,_•,iv--d t•1•11 ~1.!f\•-..,. "·c;ut di11wri thl" y::.11, I>~ I J Pr,;.f"i• ,lf:""r d.-..-!~;:•Li:: f11~ r '.'.';)Jr,c 11( 11? c.,pctbC"', J~~ - I. "i(•!~·r:ml~ ~.:clarc .111J ~onfi1m :l,at the p,Hi1•. 11:.,r t1..,.:n ,,bov1! .trt: 1,uc h• 1bc l,1_-s1 •i( nw k,1owk.ig,: atu.l hchcf :sJ :.,:~t,,\<'11-\I!\ 1 !i:n1ps-rson JAli\ r ""· ,.~,E,11 ,, 1r,11~ou111 1'1rnh:. rr :11 .. \1.til◄!;,l;f, Ci11vl. ,J fooJ1~ l'ri:,~ ... Hing, R,i.,d May~puu, N~w fN!h1-J lfXJ•,.:l ,1,nd Pulili-.n~>d h)' 1h~ C'11111rol!cr orf'ubli..:utwn,., D.:llu-1 WU~,J 2()<1J0 I! I 0