Please complete the form below

Delegated Authority ATE Insurance

1. YOUR CLIENTS DETAILS

Your Clients Name
(eg Mr Alan Sugar Lord)

Prefix

First

Last

Suffix
Date of Birth
(eg dd/mm/yyyy)
Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Clients Contact Number
(Landline)
If Available
Clients Contact Number
(Mobile)
If Available

2. LITIGATION FRIEND DETAILS - (If Applicable)

Litigation Friend

Prefix

First

Last

Suffix
Relationship To Claimant

3. CASE DETAILS

Claim Type
Date of Incident (Accident)
(eg dd/mm/yyyy)
Date of CFA
(eg dd/mm/yyyy)
Opponents Name

4. REPRESENTATIVE DETAILS

Law Firms Name
(Your Trading Style)
Your Reference
Introducer
if applicable
Introducer Reference
if applicable
Fee Earner's Name
(Submitted By)

First

Last
Fee Earner's Email *
(The policy will be sent to the email address stated here)
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Judgments

Burgess v J Breheny Contracts Ltd

In 2009 this judgment decided that an After The Event Insurance Policy that was taken out following an admission of liability is recoverable.

Tilby v Perfect Pizza (2002)

Deferred Premiums are not subject to the Consumer Credit Act.

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DELEGATED REPORTING REQUIREMNETS

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Authority to issue Proceedings (ATIP)- Online Reporting, click here.

Authority to serve Proceedings (ATSP) - Online Reporting, click here.

Authority to proceed to Trial (ATPTT) - Online Reporting, click here.

Authority to reject Part 36 offer (REJ360) - Email, Fax or Post, details of Part 36 Offer, why the solicitor wishes to reject the offer. Copy of Counsel's Opinion regarding liability/quantum (if available), medical report, details of claim (i.e Claimant's witness Statement/Paticulars of Claim).

Notification of any fact or evidence materially affectings the Client's prospects of success in the case where a reasonable Panel Solicitor condiders whether indemnity should contiune (COFC) - Email, Fax or Post, details of the change of fact/evidence and why the Panel Solicitor feels indemnity should be continued. The Panel Solicitor will notify us where there has been or as soon as they become aware of any material change of fact, circumstances or development that is likely to affect the prospects of success or otherwise alter the risk and or which may give rise ro a potential claim on the policy and or where there has been a change od relevant law.

Notification of any fact or evidence materially affecting the Client's prospects of success in the case where the Panel Solicitor considers indemnity should be withdrawn (COFW) - Email, Fax or Post, details of the change of fact.evidence and why the Panel Solicitor feels indemnity should be withdrawn. The Panel Solicitor will immediately notify us where there has been or as soon as they become aware of any material change of fact, circumstances or development that is likely to affect the prospects of success or otherwise alter the risk and or which may give rise to a potential claim on the policy and or where there has been a change of relevant law.

Any failure by the Client to provide instructions or otherwise to cooperate with the Panel Solicitor in the conduct of the Proceedings (NONCOOP) - Email, Fax or Post, details of the Panel Solicitor's attempts to contact the client.

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