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Become a DAIS Partner

Apply now to join Direct Access Insurance Services – Take 10 minutes to complete the initial DAIS application and our team will be in touch shortly to discuss next steps

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Agency Profile

Agency Address
E&O Carrier Name
Please mark the top 5 types of business your agency focuses on:

System Information:

Agency Management System Name
Comparative Rater Vendor Name

Does your agency have a book of business that you want to roll?
Has the agency or any principal of the agency ever been subject to any Dept of Ins action regarding a violation?
Have there been any E&O claims made against the agency, partners, officers, owners or producers in the past 5 yrs?
Has the agency, partners, officers or owners filed, or is in the process of filing, for Bankruptcy in the past 5 yrs?
Have any partners, officers, owners or producers ever been convicted of a felony?