Customer Authorisation Form

To be completed by the Customer, Authorised Signatory or Group Secretary

Please complete the standard Customer Authorisation Form and WTW will obtain quotations on your behalf - signing does not commit you to purchasing or changing any cover. One of our consultants will then talk you through the options available.

After you sign this form


  • You will receive a copy of the signed form by email.
  • WTW will contact your insurer(s) directly to obtain the information needed to prepare quotations on your behalf, helping reduce the amount of information you need to provide manually.
  • Once your quotations are ready, a WTW consultant will contact you to talk you through them and answer any questions.
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Optimal Benefits by WTW

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