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LOUISIANA STATE CHAPTER OF IASIU

2007

MEMBERSHIP APPLICATION

Please circle one.          Renewal Application                          New Membership

Please circle one.          Regular Membership                        Associate Membership  

Law Enforcement Member               Retiree Member                

Regular Members must be members of The International Association of Special Investigation Units.  IASIU Member Number:                 

Applicant Information

Name:  Last_________________________ First _______________ MI __________

Employer: ___________________________________________________________

Employer Address: ____________________________________________________

                                ____________________________________________________

Telephone: _________________________ Fax: _____________________________

Email Address: _______________________________________________________

Work Title: __________________________________________________________

New members must be sponsored by two regular members of the Louisiana State Chapter of IASIU.

Sponsor Name _____________________     Sponsor Name________________________

 I hereby make application for membership in the Louisiana State Chapter of Special Investigation Unit in accordance with the Constitution and Bylaws and agree to be bound therewith.  All of the information contained in this application is subject to acceptance by the Board of Directors of the Louisiana Chapter.  If my employment duties change so as to fall outside the requirements for membership, my membership in the organization shall terminate. 

Signature: __________________________________ Date: ___________________ 

LOUISIANA STATE CHAPTER OF IASIU

MEMBERSHIP APPLICATION

2007

REGULAR MEMBERSHIP shall include: (1) Insurance company employees whose primary purpose is the full-time investigation and/or supervision of investigation of insurance fraud.  (2) An employee of a self-insured corporation who is employed and assigned to a Special investigation Unit and whose primary purpose is the full-time investigation and/or supervision of investigation of insurance fraud.  The individual and the organization must be engaged in anti-fraud activities and must be in conformance with the goals and objectives of the association.  Provided, however, any such individual whose professional activities and interests of the association shall not be deemed eligible for membership.  (3) An agent, special agent or the National Insurance Crime Bureau (US), the Insurance Bureau of Canada, Larmtjanst AB ( Sweden), the Danish Insurance Association (Denmark), Norwegian Insurance Federation (Norway), Finnish Motor Insures’ Centre (Finland) Insurance Federation (Finland).

ASSOCIATE MEMBERSHIP shall include: (1) Local, state, federal, provincial, or similar governmental entities’ law enforcement officer, or prosecutor who is involved in, or provides special expertise or services for the investigation and/or prosecution of insurance fraud crime.  (2) A full-time investigator or investigations supervisor of a state insurance fraud bureau.  (3) Any employee of an insurance company or any employee of a government agency who is involved in, or provides special expertise or services for the investigation of insurance fraud, who is endorsed in writing by a regular member.

RETIREE ASSOCIATE:  Regular and associate members that retire and are not currently employed in the insurance industry or ins a capacity ineligible for membership, are eligible to continue membership as an associate member.

THIRD PARTY ADMINISTRATOR/GENERAL AGENCY ASSOCIATE:  Employees of TPA’S or general agencies who are involved in, or provide special expertise or services for the investigation of insurance fraud, who is endorsed in writing by a regular member.

Associate membership shall be granted at the discretion of the board of directors.  Associate members shall have the privilege of regular members except they may not hold office and may be excluded from any business meeting by a majority vote of regular members present. 

IASIU CODE OF ETHICS

I.                    Members shall perform their duties in accordance with the law, and shall observe the highest moral principles in doing so.

II.                 Members shall at all times act with integrity, truthfulness and honesty, modeling behavior exemplary or our profession.

III.               Members shall observe diligence in the discharge of their professional responsibilities.

IV.              Members shall exhibit competence at all times in the discharge of their professional responsibilities.

V.                 Members shall at no time divulge confidential information in an inappropriate or unlawful manner, and shall exercise the care required to prevent unlawful or improper disclosure.

VI.              Members shall not maliciously injure the reputation or professional practice of colleagues, employers, insured, claimants or other parties to investigations.

VII.            Members shall display the requisite courage to make the right decision when faced with potential conflicts of interest.

MEMBERSHIP FEES LOUISIANA STATE CHAPTER IASIU:

If paid on or before March 31, 2007:           $25.00

If paid after April 1, 2007:                           $30.00

Fees are applied to membership for the calendar year of January 1, 2007 through December 31, 2007.  Make all checks payable to LA IASIU.  Checks must be attached to the Membership Application and mailed to:

LA State Chapter of IASIU

6660 Riverside Dr.

Suite 100

Metairie, Louisiana 70003