Referrer Agreement Form | Freight Insurance Services

Become a referral partner

Become a Freight Insurance referrer and earn commission on the transit insurance your clients buy through your personalised link. Complete the agreement below to get started.

10% commission on policies taken up through your personalised URL on your website, quotes or email signature.
Paid monthly: referral fees are paid at the end of the calendar month once the invoice has been paid in full.
No claims handling: your customers deal directly with us, and we manage any claim without your involvement.
Backed by AXA XL and our automated online quoting platform.

Before you start, have ready: your company name and ABN, the bank account for referral payments (bank, BSB, account number and remittance email), and details of your current insurance. You will review a draft of the agreement before you sign and submit it.

Questions about the program? Call 1800 656 836 or read more on our Partner With Us page.

Business Details

Company Name(s)

Legal entity name of the Spotter/Referrer.

ABN

11 digits, e.g. 15 098 158 975.

Banking Details

Referral fees are paid to this account at the end of the calendar month once the invoice has been paid in full.

Name of Bank

BSB

6 digits, e.g. 012-345.

Account Number

Account Name

Remittance Email Address

Insurance Details

Do you currently have Freight Forwarders Liability Insurance or Professional Indemnity Insurance?

Yes No

Insurer Name

Expiry Date

DD/MM/YYYY, e.g. 30/06/2027.

Do you currently have Public Liability Insurance?

Yes No

Insurer Name

Expiry Date

DD/MM/YYYY, e.g. 30/06/2027.

Industry Associations

If you are involved with any industry association please confirm details below.

Details

Member Since

e.g. 2019 or March 2019.

Partnership Option

Please select which Freight Insurance options you would like us to organize for you.

Access Freight Insurance website via Agent Login for cargo insurance referrals for your client's cargo

Specially coded URL for your client to self-serve to arrange freight insurance on their cargo in transit within Australia or Overseas

Signatory & Declaration

By submitting this form to HWA Insurance Brokers, the signatory declares that they are authorised to make this declaration on behalf of the person(s) and entities named above.

Business Address

Name of Signatory (full name)

Title of Signatory

Contact Number

Website

I confirm the details above are accurate and correct to the best of my knowledge, and I am authorised to sign this Agreement on behalf of the entity named above.

Preview downloads the completed agreement so you can check it. Submit shows you the full agreement to review and sign before it is sent to HWA Insurance Brokers.

If You Have Any Questions, Please Feel Free to Contact Us

1800 656 836