Letter of Appointment

This application will sign over your policies to be managed by VIM Cover.

    Appointment Effective Date

    It's important you enter the correct policy numbers for each policy bringing over to Shielded

    Please sign before submitting

    Preview of Appointment Letter

     
    Date: 
     
    To Whom it May Concern:
     
    This letter confirms the appointment of (as an Authorised Representative of Oracle Group (Australia) Pty Ltd, AFSL No. 363610) as the provider of insurance services effective from the above date.  Either party may terminate this appointment by written notice of not less than 30 days to the other.  Such notice is to include the reason for the termination together with an opportunity to redress if requested.
     
    We acknowledge that the applicable insurance Product Disclosure Statement (PDS)\Policy Wording will be that arranged by our newly appointed broker, effective from the date of this Letter of Appointment.
     
    We appoint to manage all our my insurance requirements in respect of the following services;
     
    • Advising in matters relating to risk identification and transfer;
    • Arranging our general insurance requirements;
    • Negotiation of policy coverage, policy renewal, policy changes and cancellations;
    • Review and advising in matters relating to claim circumstances and management; 
    • Advising in matters relating to risk management;
    • Advising and arranging statutory insurance as required e.g. Workers’ Compensation
    • Attend to correspondence and the provision of advice as required from time to time
     
    For the following insurance policies:
     
    Policy No.: Due Date:
     
    Claim No.: Date of Loss:
     
    The undersigned understand and agree that this Letter of Appointment overrides any previous appointment we may have made to any other broker.
     
    Client Name: Title:  
     
    Signature:  Date: 
     
    Contact Number: Email:

     

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