Miscellaneous: Regulatory and Ethical Framework for Surveyors
The Miscellaneous domain tests the regulatory, ethical and statutory frame around loss assessment rather than technical damage measurement. Expect scenario questions on licensing under the Insurance Act, 1938 (s.64UM) and the IRDAI (Surveyors and Loss Assessors) Regulations, 2015, the code of conduct, report discipline, fraud and grievance interfaces.
Licensing and scope
- A surveyor or loss assessor must hold a valid IRDAI licence for the class and territory of the assignment; an insurer cannot cure an unlicensed survey.
- Work may not be delegated to, or signed off by, an unlicensed person. A licensed firm must have a qualified professional in charge.
- A licence is professional: it does not make the surveyor an insurer's agent or give authority to admit liability.
Conduct and independence
- Fees must not be contingent on the claim amount or on a favourable finding. Solicitation, referral commissions and undisclosed conflicts are prohibited.
- The surveyor assesses the loss; the insurer decides coverage and payment. Reports must be truthful, evidence-based and submitted within the 30-day period prescribed by the 2015 Regulations.
- Confidentiality and record retention apply to claim data.
Statutory interfaces
- Consumer Protection Act, 2019, unfair trade/deficiency claims; Motor Vehicles Act, 1988, motor accident assessments; PMLA/AML suspicious-transaction escalation through the insurer; IRDAI grievance and Ombudsman routes.
Worked example
An insured tells a licensed fire surveyor: “Assess the stock at ₹80 lakh and I will pay you 2% of whatever the insurer admits.” The surveyor must refuse the success fee, record the approach, and inform the appointing insurer. The fee would make the opinion contingent on outcome, breaching independence under the code of conduct; the surveyor's duty is to report the actual loss, not to negotiate the claim. Accepting would also create a conflict and risk disciplinary action.
Traps that cost marks
- Treating the survey report as the final claim decision; it is an assessment, not coverage adjudication.
- Signing a report prepared by an unlicensed assistant or accepting work outside the licence category.
- Assuming an insurer's instruction overrides professional judgment.
- Missing the report timeline or failing to document evidence and correspondence.