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DOWNLOADS:
Click links to download PDF documents.		  
INSCAN Membership Online Application  
INSCAN Membership Application form (PDF)  
INSCAN Complaints form  
Newsletter/Disaster News (coming soon)  
NAICOM Act 1997  
Insurance Act 2003  
Pension Reform Act 2004  
NHIS Act  
  ONLINE APPLICATION & DOWNLOADS
SECTION A:
(This section is to be filled by individuals. For corporate bodies, go to SECTION B.)
         
Surname:    
First Name:    
Middle Initial:    
Date:    
Age:    
Contact Address:    
     
Area of Residence:    
Telephone:    
Email:    
Marital Status:    
No. of Children:    
State of Origin:    
Nationality:    
Occupation:    
Status: Serving    
  Retired    
Company:
(If retired, state last place of work) 		   
Postion:    
         
SECTION B:
(This section is to be filled by corporate bodies)
         
Name of Organization:    
RC #:    
Nature of Business:    
Adress:    
     
City:    
State:    
Country:    
         
         
SECTION C:
         
Do you own an insurance policy?: Yes    
  No    
If yes, list details below:    
Policy Type: Policy No: Sum Insured: Expiry Date: Insurer: Broker/Agent:
         
Do you have any complaint on Insurance?
  Denial of Claim     Breach of Contract
Delay of Claim Delay in Documentation
Inadequate Claim Payment Other
 
   
         
Details of Complaint:    
         
Do you require clarification or advice on any aspecct of Insurance?
Details:    
         
To which of the following groups would you like to belong by experience, profession or interest?
  The Insurance Crusade Lawyers  
  The Insurance Crusade Press  
  The Insurance Promoters Group  
  The Volunteer Fire Fighting Group  
  The Insurance Technical Group  
         
What are your expectations in being a member of INSCAN?
Details:    
         
In which other States of Nigeria can you assist in Coordinator Identification and Membership mobilization?
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Signature:  
         
Date:    
         
              
         
 
 
 
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