NSIPA CIPA | CIPTA Reference Form

Through the reference process outlined below we hope to ascertain your opinion of the candidate's merit for receiving the professional designation of CIPA, including evidence of compliance with the National Society of Insurance Premium Auditors’ Code of Professional Ethics.

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Applicant's Name *

Capacity: In what capacity have you known the candidate and for what period of time?
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NSIPA Code of Professional Ethics

"As a premium auditor, I will...

...be prudent in the use of information acquired in the course of my duties.
...provide a high standard of professional service to all policyholders.
...strive to improve my professional knowledge, skills and competence.
...perform my duties in a dignified and professional manner.
...not enter into any activity which is or may appear to be in conflict with the interest of
my employer.
...not injure the professional reputation or practice of another premium auditor.
...cooperate in exchanging non-confidential information and experience with other premium auditors."

Do you believe the applicant is worthy of this designation as evidenced by adherence to the NSIPA Code of Professional Ethics?

Reason For Belief Regarding Ethics
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Is there additional information you feel noteworthy to include?
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