Insurance Adjusters Forms

The online application system has recently been enhanced and currently applies to all application categories (New, Amendment, Reinstatement, and Reinstatement + Annual Renewal).

Refer to the User Guides before submitting an application to the ICM.

*Insurance Adjuster Applications who are applying for a Level 1, 2, 3 or 4 licence are Authorized by (sponsored by) the Designated Representative of the adjusting firm

**Insurance Adjuster Applications who are applying for the Designated Representative licence are submitted directly to the ICM

Application for Provincial Examination

Online Application (*all categories)

Certificate of Authority / Non-Resident Endorsement Request Form

Supervision Agreement (*new as of Jan 1/24)

Where You'll Find Us

466-167 Lombard Avenue
Winnipeg, Manitoba
R3B 0T6
  • PHONE:
    (204) 988 6800
  • FAX:
    (204) 988 6801