INSURANCE R E GULATOrIY AND in DEVELOPMENT AUTHORITY IRDA/NL/ ORD/M ISC/ 096/04/2012
27th April, 2012
To All Licensed Surveyors and Loss Assessors
Reference is drawn to Regulation 19(b) of Insurance Surveyors and Loss Assessors (Licensing Professional requirements and Code of Conduct) Regulations, 2000 on "Submission of Returns" by all licensed surveyors and loss assessors. Accordingly, all surveyors (individual & corporate) holding valid license issued by the IRDA under the above mentioned regulations, to act as Surveyors and Loss Assessors, are henceforth required to submit their annual return in the form prescribed by the Authority, FORM-IRDA-12 (format enclosed) giving complete details of number of surveys done, quantum of losses assessed and income derived from survey work during previous financial year, latest by 30th April of the following financial year. All licensed surveyors are required to strictly comply with the above requirement.
Randip Sing (HOD - Non Life)
w WR' `r WR, 1-1, NUWK- 500 004 . t7 ; Parisharam Bhavan , 3rd Floor, Basheer Bagh, Hyderabad -500 004 . India. 0 : 91-040- 2338 1100, kW: 91-040-6682 3334 Ph.: 91-040-2338 1100, Fax: 91 -040-6682 3334 f-mac : irda@ irda.gov .in 44: www. irda.gov.in E-mail : irda@irda .gov.in Web.: www . irda.gov.in
INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY FORM - IRDA -12 (See Regulation 19(b)) FORMAT FOR ANNUAL SUBMISSION OF RETURN TO THE AUTHORITY 1. Name 2. Current Licence No. & Date of Expiry
3. Qualifications acquired in the past one year : Academic/Professional Insurance
Training Attended (Nature and duration) 4. No. of surveys done in last financial year and the name of insurers: 20 - - 20 Insurers A
Fire
Mrn. Cargo
Mrn. Hull
Engg.
Motor
Misc.
LOP
Total
B
C D
5. Quantum of losses assessed in last financial year: 20 - 20 Fire
>10
No .
M rn. C argo
No.
Mrn . Hull
Engg .
>10 lacs
>2.5
25,000-1 lac
2.5-10 lacs 0-2.5 lacs
50,0002.5 lacs 050,000
Lacs
1-10 Lacs 0-1 Lac Total
No.
>1 lac
No.
Motor
No.
Misc .
LOP
>1 lac
>10
10,000 -50,000 010,000
25,0001 lac 025,000
1-10 Lacs 0-1 Lac
lacs
0-25,000
No.
>50,000
Lacs
a) Income derived from survey work during the year. Rs. b) Profit after deducting for management expenses. Rs. I. .................................. solemnly declare and confirm that the particulars given above are true to the best of my knowledge and belief. Signature Name SLA No.
No.
