Riya
FAIS RoA Generator
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Africa Bloom (Pty) Ltd
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Starter — 10 RoAs — R100
Standard — 40 RoAs — R400
Pro — 100 RoAs — R1,000
Catch-Up — 250 RoAs — R2,500
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FSP & Representative
Section A
FSP / Broker Name
FSP Licence No.
Representative Name
Advice Date
FSP Physical Address
Compliance Officer
PI Insurance in Place
Select
Yes
No
Client Communication Method
Trigger Event
Section B
What is the reason for this RoA?
New Policy
Renewal
Amendment
Telephone Advice
Renewal Details
Policy Number Being Renewed
Current Insurer
Current Annual Premium
Renewal Premium Offered
Changes to Sums Insured Since Last Renewal
Has Client's Risk Profile Changed?
Select
No material change
Yes — details below
Re-marketed to Other Insurers?
Select
Yes — comparison below
No — renewal competitive
Amendment Details
Policy Number Being Amended
Nature of Amendment
Select type
Adding a vehicle
Removing a vehicle
Sum insured change
Adding an all-risk item
Address change
Driver change
Other endorsement
Amendment Description
Telephone Advice Record
Date of Call
Time of Call
Nature of Enquiry / Advice Given
Follow-up Action Required
Confirmation Sent to Client
Select
Yes — email sent
Yes — WhatsApp sent
No follow-up required
Client Information
Section C
Client / Insured Name
Contact Number
ID / Company Reg No.
Client Type
Personal Lines
Commercial Lines
Email Address
Insured Address / Risk Address
KYC / FICA & POPIA
Section D
ID / CIPC Verified
Select
Yes — certified copy on file
Yes — eKYC verified
Pending
Proof of Address
Select
Yes — on file, not older than 3 months
Pending
Not required (commercial)
POPIA Consent
Select
Yes — signed consent on file
Yes — digital consent captured
Pending
Claims History Declared
Select
Yes — declared, no material claims
Yes — claims declared (see below)
Not yet declared
Claims History Notes (if applicable)
FAIS Disclosure Document
Select
Yes — provided and acknowledged
Pending
Needs Analysis
Section E
Personal Lines
Commercial Lines
Motor Vehicles
Vehicle 1
Year
Make
Model / Variant
Registration Number
Retail Value (R)
Primary Use
Private
Business
Both
Regular Driver Age
Tracking Device
None
MiX Telematics
Netstar
Tracker
CarTrack
Other
Financed?
No
Yes — bank noted on schedule
Overnight Parking
+ Add Another Vehicle
Buildings (if applicable)
Does client own their home?
Select
Yes — freehold
Yes — sectional title
No — renting
Construction Type
Select
Brick & mortar
Timber frame
IBR / steel
Thatch roof
Roof Type
Select
Tiles
IBR / corrugated iron
Thatch
Concrete slab
SANS Replacement Value (R)
Sectional Title?
No — freehold
Yes — body corporate insures shell
Security Measures
Household Contents
Contents Sum Insured (R)
Basis
Replacement value
Indemnity value
Under-insurance Discussion
Select
Discussed — client confirmed sum insured is adequate
Discussed — client aware of average clause risk
Not applicable
All-Risk / Portable Items
Scheduled Items (list individually above threshold)
Unscheduled All-Risk Limit (R)
Personal Liability
Liability Cover Required
Yes — included in household policy
Yes — standalone
No
Liability Limit (R)
Existing Cover & Gaps
Current Policies in Place
Identified Gaps or Duplications
Business Profile
Nature of Business
Annual Turnover (R)
Number of Employees
Commercial Motor / Fleet
Number of Vehicles
Fleet Replacement Value (R)
Vehicle Types & Use
Tracking / Telematics
PrDP Compliance
Select
All drivers hold valid PrDP
Some drivers — details below
Not applicable
Overnight Parking / Yard Security
Goods in Transit (GIT)
GIT Cover Required?
Select
Yes
No
Per Conveyance Limit (R)
Type of Goods
Special Conditions / High-Value Loads
Premises & Assets
Premises Description
Buildings Sum Insured (R)
Contents / Stock Sum Insured (R)
Liability Covers
Public Liability Required
Select
Yes
No
Public Liability Limit (R)
Employers Liability
Select
Yes
No
Business Interruption
Select
Yes
No
Existing Cover & Gaps
Current Policies in Place
Identified Gaps or Duplications
Market Comparison
Section F
Document quotes obtained from the market. FAIS requires a reasonable range of products to be considered before recommending.
Option 1
Insurer / UMA
Annual Premium (R)
Standard Excess
Key Inclusions
Key Exclusions / Conditions
Reason Not Recommended
★ Recommended
Insurer / UMA
Annual Premium (R)
Standard Excess
Key Inclusions
Key Exclusions / Conditions
Reasons for Recommendation
Option 3
Insurer / UMA
Annual Premium (R)
Standard Excess
Key Inclusions
Key Exclusions / Conditions
Reason Not Recommended
Insurer Financial Strength & Claims Reputation Assessment
Product Recommended
Section G
Insurance Class
Recommended Insurer / UMA
Annual Premium (excl. VAT)
Sum Insured / Limit
Cover Basis
Select
Comprehensive
Third Party, Fire & Theft
Third Party Only
All Risks
Named Perils
Indemnity
Replacement Value
SASRIA Levy Included?
Select
Yes — included as per statutory requirement
Not applicable
Material Exclusions, Warranties & Special Conditions
Excess Structure
Remuneration & Conflict of Interest
Section H
Broker Remuneration
Conflict of Interest Declaration
Replacement Advice
Section I
Is an Existing Policy Being Replaced?
NO — New cover, no existing policy replaced
YES — Existing policy being replaced
Existing Policy Details
Reason for Replacement
Replacement in Client's Best Interest
Select
Yes — confirmed in writing
Yes — client acknowledges in RoA
Client Acceptance
Section J
Method of Acceptance
Select
Signed RoA — original on file
Email confirmation from client
WhatsApp confirmation — screenshot on file
Verbal — recorded call
Digital signature
Date of Acceptance
Client Deviation from Recommendation
None — client accepted recommendation
Yes — client chose differently (document below)
Deviation Details
Additional Material Facts
Generate FAIS Record of Advice
Record of Advice — FAIS & GCoC Compliant Output
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