Australia - Partners

Europ Assistance Partner Eligibility Check​

Please fill out the form below, and our team will review your details and get back to you shortly.

Partner Eligibility Check Form - Envoyage Advisor

If you need assistance or have questions related to the Eligibility Check process, please reach out to our partnership team partnersupport@europ-assistance.com.au

As an Advisor, you will be utilising the On Account Payment method. On Account functionality allows advisors to issue policies and have these reconciled on a weekly statement
3. Address
6. Your Full Name

As an Advisor, you will be utilising the On Account Payment method. On Account functionality allows advisors to issue policies and have these reconciled on a weekly statement

8. Have you personally declared for bankruptcy or had a negative credit score while distributing insurance products?
9. Do you consent for Europ Assistance to run a credit/ bankruptcy check?
10. Do you declare that no director, CEO, or any person involved in distributing the insurance product has been found guilty of crimes or subjected to disciplinary measures related to financial, securities, or insurance activities, including fraud, financial crime, or other serious offences under company, bankruptcy, insolvency, or consumer protection laws.
11. Do you provide consent for Europ Assistance Australia to conduct a criminal check?
12. Do you consent, in your capacity as authorised representative of the entity, to Europ Assistance Australia's Privacy Policy and the processing of the entity/relevant personnel’s personal information in line with this policy?
13. I confirm that I am part of the Envoyage group, adhere to Envoyage’s Privacy Policy, and am covered under Envoyage’s Professional Indemnity Insurance

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