Thank you for completing the Delegated Authority Qualification Questionnaire

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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

Opportunity details

i.e. new delegated underwriting authority (DUA)/periodic retender/additional capacity required etc.

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

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

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

Which territories is the business written in? (optional)

Please select all that are applicable

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)

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)

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

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

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

i.e. Bordereaux, Xchanging, statement of account

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

What's the policy wording required? (optional)

Delegated Authority Requirements

Will there be claims delegation? (optional)
Is delegation administration required? (optional)
What's the level of delegated underwriting authority required? (optional)
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)

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.

Privacy Policy

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