NZ UAC - Initial Questionnaire
Note: This is not an application for membership.
Your Company Name *
Subsidiary entities (if any)
Your Street Address (main branch)
Your Postal Address *
Main Phone Number
Company Email address *
Main contact person - Name *
Main contact person - Email address *
Main contact person - Contact Phone and Mobile numbers
Insurance Products arranged *
Do you have Claims Settling Authority *
Total number of staff employed within the business *
How many Principals & Directors do you have?
Number of Claims, Technical & Underwriting staff
Number of Administration & Accounting staff
Do you operate a governance board? *
If you do operate a governance board, how many independent members/directors sit on the 'board'?
What are the issues you would like NZUAC to address for you? *
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