UpSure

Letter of appointment

Use this form if you've got existing insurance plans or an old broker in place and we'll sign you over to UpSure free of charge and help you manage your existing policy until renewal (assuming it's all in good order etc, but we'll let you know if any issues with existing policy before porting over).
Full name

First NameLast Name
Business name
Types of insurances currently in place

General LiabilityWorkers CompenstationProfessional IndemnityBusiness PackOther
If other, quickly describe, or if don't know that's fine too we'll help figure it out :)
Upload any coverage documents you currently have for review.

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Upload a letter head or logo of your business (we'll turn into formal letter of appointment for signature)

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Referred by
I appoint HubSpoke Insurance Pty Ltd (ACN 638 890 687) t/as UpSure (UpSure) of 265 King Street Bowen Hills, QLD 4006 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;·
Negotiating policy coverage,
policy renewal,
policy changes and cancellations;·
Reviewing and advising in matters relating to claim circumstances and management;·
Advising in matters relating to risk management;·
Advising and arranging statutory insurances as required eg. Workers’ Compensation;·

Attending to correspondence and the provision of advice as may be required.

I acknowledge having read and accepted the Terms of Engagement and Financial Services Guide produced by UpSure and outlined on the following page.

I authorise our current insurer(s) to provide UpSure with all information they request regarding our insurances and claims history in respect of our insurance.

This appointment replaces any existing arrangement in place between us and any other insurance intermediary formally appointed to advise on or arrange or negotiate our insurance requirements as described above.

This appointment is invalid if the insurances described above have not been arranged by the insurance broker appointed by this letter or if this letter is not submitted to the insurers within 90 days of the effective date described.
First nameLast name
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Letter of appointment