Delegated Authority Qualification Questionnaire

Please fill out the below form with as much information as possible. Nothing in this form shall be legally binding on either party and nothing herein shall obligate Aviva or you to proceed with any transaction or provision of services contemplated between us. Each party reserves the right, in its sole discretion, to terminate any discussions contemplated by this form.

Contact information

Your name

Your role

Broker/Coverholder name

Contact email address

Opportunity details

Opportunity name (optional)

What's the reason the opportunity is coming to market? (optional)

What's the size of opportunity in GWP? (optional)

What's the market size for customer type? (optional)

How many policies are there? (optional)

What's the target market? (optional)

What are the product/sections/covers required? (optional)

Are there any unique selling points for this opportunity? (optional)

What's the required deal term? (optional)

What's the proposed go live date? (optional)

Please enter the date in the format dd/mm/yyyy

Is the scheme within underwriting appetite? (optional)

Is the scheme within an existing reinsurance programme/treaty? (optional)

What's the model? (optional)

i.e. solus/panel/wholesale/co-insurance (lead, follow)/reinsurance?

What's the link to the customer group? (optional)

i.e. affinity group/specialist broker/trade association

Which territories is the business written in? (optional)

Please select all that are applicable

What's the average turnover of the customer? (optional)

What's the customer turnover range? (min/max) (optional)

If Republic of Ireland (ROI), what's the minimum turnover of any business to be written? (optional)

Is there a requirement for any Property Section or Businesses All Risks to be extended beyond temporary removal outside UK exceeding 90 days? (optional)

If yes, please provide further details.

If not on a temporary basis, will this be written FOS (Freedom of Services)/FINC (Financial Interest Clause)/admitted/non-admitted? If so, what's the proportion of the account?

If inwards reinsurance, will Aviva be contacting the broker/MGA (managing general agent) to allow them to bind cover on our behalf? (optional)

What's the name of the legal entity we'll be contracting with? (optional)

How will the scheme be administered? (optional)

i.e, manual/software house/B2C (quote and buy by the customer online)

Existing management

Is the business proposed managed under an existing facility? (optional)

If 'Yes', how long has it been established and who's the incumbent insurer? (optional)

What’s the average current monthly referral volumes to your Insurer/supplier under your existing facility? (optional)

If an existing facility, what's the historical performance? (optional)

Please provide GWP/claims/ECR information for the last 3 years, where possible.

What’s the projected growth of the scheme? (optional)

Include short term and long term growth plans and how you expect to achieve this.

If not an existing facility, how is the scheme is expected to develop? (optional)

If you have a business plan please outline your thoughts here.

Is pricing based on Aviva price or third-party pricing? (optional)

Aviva
Third-party

What's the collections process? (optional)

i.e. Bordereaux, Xchanging, statement of account

What are your renumeration requirements? (optional)

i.e. commission, work transfer fees, profit shares, upfront payments

What's the policy wording required? (optional)

Aviva standard wording
Aviva based wording with changes
Third-party wording

Delegated Authority Requirements

Will there be claims delegation? (optional)

Is delegation administration required? (optional)

If yes, which elements are delegated? (optional)

What's the level of delegated underwriting authority required? (optional)

Full discretionary
Non-discretionary
No delegation of underwriting authority required

Is delegated authority sub-outsourced to another third party? (optional)

Is there a percentage of the business within the Delegated Underwriting Authority (DUA) currently under long-term agreement or rate stability agreement? (optional)

If yes, when does it expire and what proportion of the book is under such arrangement? (optional)

Is there a DUA(s) already held with Aviva or other insurers? If yes, please provide details (optional)

Next steps

By submitting this form, you agree that the information provided is to the best of your knowledge complete and accurate. You agree to promptly notify us if there is a material change to any of the information you provided. Once you have submitted this form, your details will be passed to a member of the Commercial Delegated Authority Development Team who will use reasonable endeavours to be in touch within 48 hours.

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Delegated Authority Qualification Questionnaire