- Purpose: To officially switch your insurance broker. This means your new broker now has the authority to act on your behalf with your insurance carrier(s).
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Key Information Included:
- Your company's name and address.
- The name and address of the new insurance broker.
- A clear statement appointing the new broker as your "broker of record."
- The effective date of the change.
- Signatures of authorized representatives.
- When it's Used: Typically, this letter is issued when a policyholder decides to switch insurance brokers. This could be due to dissatisfaction with the current broker, seeking better rates, needing specialized expertise, or a change in business needs.
Broker of Record Letter Sample Insurance for Switching Brokers
When you've decided to move your insurance business to a new agency, the broker of record letter is your official handshake with your new partner.
- Policyholder Name
- Policyholder Address
- Date
- New Broker Name
- New Broker Address
- Statement of Appointment
- Effective Date
- List of Insurance Carriers
- List of Policy Numbers
- Authorization to Receive Information
- Authorization to Make Changes
- Confidentiality Clause
- Contact Person at Policyholder Company
- Title of Signatory
- Signature of Authorized Representative
- Printed Name of Signatory
- Company Seal (if applicable)
- Confirmation of Receipt Request
- Previous Broker Notification (optional)
- Next Steps for New Broker
Broker of Record Letter Sample Insurance for Adding a New Policy
Sometimes, even with an existing broker, you might need to formally designate them as the point person for a brand-new insurance policy you're taking out.
- Policyholder Name
- Policyholder Address
- Date
- Designated Broker Name
- Designated Broker Address
- Statement of Designation for New Policy
- Effective Date for New Policy
- Specific New Policy Type
- New Policy Number (if assigned)
- Insurance Carrier for New Policy
- Authorization to Manage New Policy
- Purpose of New Policy
- Contact Person for New Policy
- Title of Signatory
- Signature of Authorized Representative
- Printed Name of Signatory
- Confirmation of Understanding
- Future Policy Renewals
- Terms and Conditions
- Acknowledgment of Services
Broker of Record Letter Sample Insurance for Clarifying Responsibilities
This type of letter helps to avoid any mix-ups about who is handling which aspect of your insurance coverage, especially if you work with multiple brokers for different needs.
Broker of Record Letter Sample Insurance for Mid-Term Policy Changes
If you need to make significant adjustments to your existing insurance mid-term and want to ensure your chosen broker is the one managing those changes, a specific letter might be necessary.
- Policyholder Name
- Policyholder Address
- Date
- Broker of Record Name
- Broker of Record Address
- Statement for Mid-Term Change
- Effective Date of Change
- Policy Number Affected
- Nature of the Change
- Insurance Carrier
- Authorization to Implement Change
- Reason for Mid-Term Change
- Impact Assessment
- Confirmation of Terms
- Contact for Questions
- Authorized Signatory
- Printed Name
- Title
- Date of Signing
- Acknowledgment of Carrier Notification
Broker of Record Letter Sample Insurance for Mergers and Acquisitions
When companies combine or one takes over another, it's crucial to re-establish who is officially managing the insurance for the new, combined entity.