New Producer Appointment Application          
 
Part #:  out of     

Please submit Part 1.  Once we review Part 1, you will receive an email from us with further instructions regarding Part 2. The same applies to Part 2.

Upload Files:  You must save this document as a "Draft" and then you will be able to upload the required files.  Please attach the current year to date and prior year end production reports for the agency’s three largest personal lines carriers from the last 3 years.

Agency/Broker Contact List & Producer Business Center/ePCG access : AIG Personal Lines maintains a proprietary internet site for all appointed Producers.  We also have ongoing communication by email whenever possible. Please provide information for ALL personal lines employees in this section (include all Principals, Producers CSRs, etc.)

Definitions*

Parent/Subsidiary Producer Codes: All Broker User ID’s that are set up under a parent broker code can view their book of business as well as all the clients of broker codes established as a subsidiary. All ID’s that are set up under a subsidiary code can only view the clients in the subsidiary’s book of business. 

QUESTIONS
* Mandatory

Agency/Brokerage Information


1. Agency/Brokerage Name and FEIN #*    
2. Mailing Address*    
3. Mailing City*    
4. Mailing State*    
5. Mailing Zip Code*    
6. Mailing Country*    
7. First Name*    
8. Last Name*    
9. Phone*    
10. Email*    
11. Fax Number    
12. Physical Address: (If different than Mailing)    
13. Physical City    
14. Physical State    
15. Physical Zip Code    
16. Type of Business*    
17. Describe Organization*    
18. Company URL    

License Information


19. Are you currently appointed by AIG commercially?*    
20. Have you been terminated by any insurance carrier in the past 5 years?*    
21. Have you ever had complaints registered against you with any Department of Insurance, or other state regulatory agency?*    
22. Have you ever been fined or disciplined by any licensing authority?*    
23. Do you currently have an Excess and Surplus License?*    
24. Carrier for your Errors and Omissions Policy?*    
    24.1. Limit*
    24.2. Deductible*
    24.3. Expiration date (MM/DD/YYYY)*    

Agency/Broker Profile


25. Have you ever been appointed with AIG Personal Lines in the past?*    
26. Do you currently utilize a wholesaler or another broker to write personal lines insurance with AIG?*    
27. Total Agency Commercial and Personal Lines Premium Volume*
    27.1. Personal Lines*
    27.2. Commercial*
    27.3. Benefits / Other*
    27.4. Do you sell life insurance?*    
28. Personal Lines Premium Volume*
    28.1. Estimate the % of total premium generated from affluent/high net worth clients (accounts with homes valued at $500,000 and higher)*     %
    28.2. New Business written year to date*
    28.3. New Business prior year end*
29. What State(s)/Region(s) do you actively market?*    
Available Options Selected Options

 
 

30. Does your agency provide your clients with financial advisory/wealth management products/advice?*    
31. Does anyone in your agency hold a Series 6 or 7 license?*    
32. What Internet Browser and version does your agency currently use?*    

Please segment your total personal lines client base by the following: (# of Clients)


33. Annual Total Account Premium: Under $5,000*     Number
34. Annual Total Account Premium: $5,000 - $9,999*     Number
35. Annual Total Account Premium: $10,000 - $24,999*     Number
36. Annual Total Account Premium: $25,000 - $50,000*     Number
37. Annual Total Account Premium: Over $50,000*     Number
38. Home Value: Under $500,000     Number
39. Home Value: $500,000 to $2,000,000     Number
40. Home Value: Over $2,000,000     Number

Supply the following information for the top 5 personal insurance carriers you are appointed with:


41. Select Carrier 1*    
    41.1. Total Personal Lines Premium Volume*
    41.2. Number of clients*     Number
    41.3. 1 year loss ratio*     %
    41.4. 3 year loss ratio*     %
    41.5. 12 month moving customer retention ratio*     %
    41.6. New business written year to date*
    41.7. New business prior year end*
42. Select Carrier 2    
    42.1. Total Personal Lines Premium Volume
    42.2. Number of clients     Number
    42.3. 1 year loss ratio     %
    42.4. 3 year loss ratio     %
    42.5. 12 month moving customer retention ratio     %
    42.6. New business written year to date
    42.7. New business prior year end
43. Select Carrier 3    
    43.1. Total Personal Lines Premium Volume
    43.2. Number of clients     Number
    43.3. 1 year loss ratio     %
    43.4. 3 year loss ratio     %
    43.5. 12 month moving customer retention ratio     %
    43.6. New business written year to date
    43.7. New business prior year end
44. Select Carrier 4    
    44.1. Total Personal Lines Premium Volume
    44.2. Number of clients     Number
    44.3. 1 year loss ratio     %
    44.4. 3 year loss ratio     %
    44.5. 12 month moving customer retention ratio     %
    44.6. New business written year to date
    44.7. New business prior year end
45. Select Carrier 5    
    45.1. Total Personal Lines Premium Volume
    45.2. Number of clients     Number
    45.3. 1 year loss ratio     %
    45.4. 3 year loss ratio     %
    45.5. 12 month moving customer retention ratio     %
    45.6. New business written year to date
    45.7. New business prior year end

What percentage of your new business is written from the following sources?


46. Referrals*     %
47. Commercial cross sell*     %
48. Direct mail*     %
49. Digital Marketing*     %
    49.1. Describe digital marketing activities:    
50. Centers of Influence*     %
    50.1. Describe centers of influence- (ie financial/wealth advisors, attorney CPA’s; or groups, clubs, or associations you are affiliated with:    
51. Other*     %
    51.1. Describe:    

Personal Lines Staff


52. Total # of personal lines staff*     Number
53. # full-time*     Number
54. # part-time*     Number
55. Does the agency have a dedicated personal lines team that specializes in handling affluent and high net worth business?*    
56. Are you a broker with AIG Property Casualty - Personal Lines Global Expatriates?*    

Please Confirm Required Documents have been Uploaded - Save as draft before uploading


57. Yes I uploaded my carrier production reports*    
58. Yes I uploaded my E&O declaration page*    

Submitter Information


59. Signed By*    
60. Signed Date*    
61. I certify that the information I provided in this online application is accurate and complete based upon my knowledge and belief at the time it was entered.*    
 
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