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1 forms found in the DOM

Name: frmBOAWNomination —

<form id="frmW2023WNomination" name="frmBOAWNomination">
  <input id="hdnFormType" name="hdnFormType" type="hidden" value="2023 Break Out Awards">
  <div class="innovationbox">
    <h4>Nomination Form</h4>
    <p>
      <span style="font-family: calibri, sans-serif;">Please complete and submit the nomination form by February 13. If you have any questions, please contact Gavin Souter, </span>
      <a href="mailto:gsouter@businessinsurance.com"><span style="font-family: calibri, sans-serif;">gsouter@businessinsurance.com</span></a><br> &nbsp;
    </p>
    <ul class="inn_list">
      <li>
        <label class="mandatory">Nominee First Name :</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="NomineeFirstName" id="NomineeFirstName " name="NomineeFirstName" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Nominee Last Name :</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="NomineeLastName" id="NomineeLastName " name="NomineeLastName" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Email :</label>
        <span> <input data-msg-email="Enter a valid email." data-msg-required="Field is required." data-rule-email="true" data-rule-required="true" data-tag="NomineeEmail" id="NomineeEmail" name="NomineeEmail" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Job Title :</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="Title" id="Title" name="Title" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Company :</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="Company" id="Company" name="Company" type="text"> </span>
      </li>
      <li>
        <label>Age on June 1, 2023&nbsp;:</label> <span> <input data-tag="Age" id="Age" name="Age" type="text"> </span>
      </li>
      <li class="clear">
        <label>Years in current job sector:</label> <span> <input data-tag="CurrentJobYear" id="CurrentJobYear" name="CurrentJobYear" type="text"> </span>
      </li>
      <li>
        <label>Years in current position :</label> <span> <input data-tag="CurrentPositionYear" id="CurrentPositionYear" name="CurrentPositionYear" type="text"> </span>
      </li>
      <li>
        <label>Principal professional responsibilities :</label> <span> <input data-tag="Responsibilities" id="Responsibilities" name="Responsibilities" type="text"> </span>
      </li>
      <li>
        <label>Firm's website :</label> <span> <input data-tag="WebSite" id="WebSite" name="WebSite" type="text"> </span>
      </li>
      <li>
        <label>LinkedIn profile (if available) :</label> <span> <input data-tag="LinkedInProfile" id="LinkedInProfile" name="LinkedInProfile" type="text"> </span>
      </li>
      <li>
        <label>Primary work address :</label> <span> <input data-tag="WorkAddress" id="WorkAddress" name="WorkAddress" type="text"> </span>
      </li>
      <li>
        <label>Region (please specify Northeast, Midwest, South or West. “United States” or “Nationwide” is <strong> NOT</strong> acceptable.):</label> <span> <input data-tag="Region" id="Region" name="Region" type="text"> </span>
      </li>
    </ul>
    <p class="clear">&nbsp;</p>
    <p>
      <label class="mandatory">Overview. Write a brief essay (limit 3,500 characters/~500 words) in the space below that tells the judges about the nominee, please be specific as to accomplishments.</label>
      <span>
        <textarea data-msg-maxwords="A maximum of 500 words is allowed here." data-msg-required="Field is required." data-rule-maxwords="500" data-rule-required="true" data-tag="Overview" id="Overview" name="Overview"></textarea>
      </span>
    </p>
    <p class="clear">&nbsp;</p>
    <p>
      <label class="mandatory">Client service. Describe the nominee’s client service skills – internal or external clients (limit 3,500 characters/~500 words).</label>
      <span>
        <textarea data-msg-maxwords="A maximum of 500 words is allowed here." data-msg-required="Field is required." data-rule-maxwords="500" data-rule-required="true" data-tag="ClientService" id="ClientService" name="ClientService"></textarea>
      </span>
    </p>
    <p class="clear">&nbsp;</p>
    <p>
      <label class="mandatory"> Expertise. Describe the nominee’s expertise in his/her field of operations, including professional accreditations, educational accomplishments, details of any products of services developed (limit 3,500 characters/~500
        words). </label>
      <span>
        <textarea data-msg-maxwords="A maximum of 500 words is allowed here." data-msg-required="Field is required." data-rule-maxwords="500" data-rule-required="true" data-tag="Expertise" id="Expertise" name="Expertise"></textarea>
      </span>
    </p>
    <p class="clear">&nbsp;</p>
    <p>
      <label class="mandatory">Leadership. Describe the nominee’s leadership qualities and achievements, including career history and managerial experience (limit 3,500 characters/~500 words).</label>
      <span>
        <textarea data-msg-maxwords="A maximum of 500 words is allowed here." data-msg-required="Field is required." data-rule-maxwords="500" data-rule-required="true" data-tag="Leadership" id="Leadership" name="Leadership"></textarea>
      </span>
    </p>
    <p class="clear">&nbsp;</p>
    <label> Recommendations. Provide three (3) recommendations from clients, managers and/or co-workers. Recommendations may be either a brief written letter or contact information so judges may contact references of those candidates who have reached
      the final stages. </label>
    <p class="clear">&nbsp;</p>
    <h4>Recommendation 1</h4>
    <ul class="inn_list">
      <li>
        <label class="mandatory">Name:</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationName1" id="RecommendationName1" name="RecommendationName1" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Email:</label>
        <span>
          <input data-msg-email="Enter a valid email." data-msg-required="Field is required." data-rule-email="true" data-rule-required="true" data-tag="RecommendationEmail1" id="RecommendationEmail1" name="RecommendationEmail1" type="text">
        </span>
      </li>
      <li>
        <label class="mandatory">Phone:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationPhone1" id="RecommendationPhone1" name="RecommendationPhone1" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Title:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationTitle1" id="RecommendationTitle1" name="RecommendationTitle1" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Company:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationCompany1" id="RecommendationCompany1" name="RecommendationCompany1" type="text"> </span>
      </li>
      <li>
        <label>Recommendation Letter Attachment :</label>
        <span class="attchmnt">
          <input data-format="fileupload" data-uploadtype="" id="btnRecommendation1Attachment" type="button" value="Upload File">
          <input data-tag="Supporting Doc1" id="hdnSupportingDocumentation1" name="hdnRecommendation1Attachment" type="hidden">
          <i>
                        <label id="hdnSupportingDocumentation1"> <a class="removefile" data-tag="SDoc1" href="javascript:void(0);" style="display: none;">Remove</a> </label>
                    </i>
        </span>
      </li>
    </ul>
    <p class="clear">&nbsp;</p>
    <h4>Recommendation 2</h4>
    <ul class="inn_list">
      <li>
        <label class="mandatory">Name:</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationName2" id="RecommendationName2" name="RecommendationName2" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Email:</label>
        <span>
          <input data-msg-email="Enter a valid email." data-msg-required="Field is required." data-rule-email="true" data-rule-required="true" data-tag="RecommendationEmail2" id="RecommendationEmail2" name="RecommendationEmail2" type="text">
        </span>
      </li>
      <li>
        <label class="mandatory">Phone:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationPhone2" id="RecommendationPhone2" name="RecommendationPhone2" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Title:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationTitle2" id="RecommendationTitle2" name="RecommendationTitle2" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Company:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationCompany2" id="RecommendationCompany2" name="RecommendationCompany2" type="text"> </span>
      </li>
      <li>
        <label>Recommendation Letter Attachment :</label>
        <span class="attchmnt">
          <input data-format="fileupload" data-uploadtype="" id="btnRecommendation2Attachment" type="button" value="Upload File">
          <input data-tag="Supporting Doc2" id="hdnSupportingDocumentation2" name="hdnRecommendation2Attachment" type="hidden">
          <i>
                        <label id="hdnSupportingDocumentation2"> <a class="removefile" href="javascript:void(0);" style="display: none;">Remove</a> </label>
                    </i>
        </span>
      </li>
    </ul>
    <p class="clear">&nbsp;</p>
    <h4>Recommendation 3</h4>
    <ul class="inn_list">
      <li>
        <label class="mandatory">Name:</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationName3" id="RecommendationName3" name="RecommendationName3" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Email:</label>
        <span>
          <input data-msg-email="Enter a valid email." data-msg-required="Field is required." data-rule-email="true" data-rule-required="true" data-tag="RecommendationEmail3" id="RecommendationEmail3" name="RecommendationEmail3" type="text">
        </span>
      </li>
      <li>
        <label class="mandatory">Phone:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationPhone3" id="RecommendationPhone3" name="RecommendationPhone3" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Title:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationTitle3" id="RecommendationTitle3" name="RecommendationTitle3" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Company:</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="RecommendationCompany3" id="RecommendationCompany3" name="RecommendationCompany3" type="text"> </span>
      </li>
      <li>
        <label>Recommendation Letter Attachment :</label>
        <span class="attchmnt">
          <input data-format="fileupload" data-uploadtype="" id="btnRecommendation3Attachment" type="button" value="Upload File">
          <input data-tag="Supporting Doc3" id="hdnSupportingDocumentation3" name="hdnRecommendation3Attachment" type="hidden">
          <i>
                        <label id="hdnSupportingDocumentation3"> <a class="removefile" href="javascript:void(0);" style="display: none;">Remove</a> </label>
                    </i>
        </span>
      </li>
    </ul>
    <p class="clear">&nbsp;</p>
    <h3>Person completing this nomination:</h3>
    <ul class="inn_list">
      <li>
        <label class="mandatory">First Name :</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="FirstName" id="FirstName" name="FirstName" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Last Name :</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="LastName" id="LastName" name="LastName" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Email :</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="Email" id="Email" name="Email" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Phone :</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="Nominated By - Phone" id="NominatedByPhone" name="NominatedByPhone" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Title :</label> <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="Nominated By - Title" id="NominatedByTitle" name="NominatedByTitle" type="text"> </span>
      </li>
      <li>
        <label class="mandatory">Company :</label>
        <span> <input data-msg-required="Field is required." data-rule-required="true" data-tag="Nominated By - Company" id="NominatedByCompany" name="NominatedByCompany" type="text"> </span>
      </li>
    </ul>
    <p class="clear">&nbsp;</p>
    <p><input id="btnSubmit" name="btnSubmit" type="submit" value="Submit"></p>
  </div>
</form>

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 * HOME
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 * AGENDA
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 * SESSION PROPOSAL
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 * NOMINATIONS FAQ
 * GALLERY
 * SPEAKER PROPOSALS
 * PRESENTATION

 * GENERAL INFORMATION
 * FAQ
   
 * NOMINATION FORM
   

The Business Insurance Break Out Awards program honors top professionals on
track to be the next leaders in the risk management and property/casualty
insurance field. Break Out Awards honorees can be from any area of the
commercial insurance sector in the United States – risk managers, brokers,
insurers, reinsurers, MGAs, MGUs, wholesalers, captive managers, TPAs, lawyers
and other service providers. 
 
While there is no age limit, nominees must have worked in the industry for NO
MORE THAN 15 years. Nominees will have already established themselves in their
careers and will be on a leadership trajectory. 
SUBMISSION DEADLINE: MONDAY, FEBRUARY 13, 2023 
 
Nominations are accepted from four regions: 

Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New
York, Pennsylvania, Rhode Island, Vermont 

Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri,
Nebraska, North Dakota, Ohio, South Dakota, Wisconsin 

South: Alabama, Arkansas, District of Columbia, Delaware, Florida, Georgia,
Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South
Carolina, Tennessee, Texas, Virginia, Washington D.C., West Virginia 

West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New
Mexico, Oregon, Utah, Washington, Wyoming 

Winners will be announced online in March and their profiles published in the
June 2023 issue of Business Insurance. The program culminates with the Break Out
Awards recognition event in Chicago in June.  
 
Eligibility: To be considered for the 2023 Business Insurance Break Out Awards,
nominees must have less than 15 years of experience in the risk management and
property/casualty insurance field and must be working in the sector on June 1,
2023. Nominees must possess exceptional leadership skills and expertise.
Evidence of such must be provided in the nomination form, which should also
include three (3) recommendations from clients, managers and/or coworkers. 
 
Judging: Honorees will be selected by a panel of senior editors at Business
Insurance. Entries will be judged and assessed based on the criteria outlined
below. The highest-evaluated entries, up to a maximum of 10 per region, will be
selected for 2023 Break Out Awards. Please note that only one (1) nominee per
company will be recognized per region. 
 
Criterion
Criterion 1: Demonstrates excellence in providing service to internal or
external clients. 
Criterion 2: Demonstrates expertise in their field of operations. 
Criterion 3: Demonstrates effectiveness in leadership. 
Criterion 4: Has not worked in the field of risk management or insurance for
more than 15 years. 
 
If you have any questions about the process, please contact Gavin Souter, editor
of Business Insurance, at gsouter@businessinsurance.com 

 

What is the Business Insurance Break Out Awards program? 

A recognition program highlighting risk management and insurance professionals
who are on track to lead the industry into the future. Honorees can be from all
areas of the insurance sector, including risk managers, retail brokers,
wholesale brokers, underwriters, claims professionals, reinsurers and other
service providers. 


How can I nominate someone for the awards? 

Nominations must be submitted using our online submission form. 


Who can make a nomination? 

Anyone familiar with the nominee can make the nomination. 

When does the nomination process end? 

February 13, 2023. No nominations will be taken after that date. 


When will the winners be announced? 

Winners will be notified and announced on BusinessInsurance.com in March. 


When will profiles of the Break Out Award winners be published? 

In the June issue of Business Insurance. 


How will the nominees be judged? Who will choose the final 40? 

The Business Insurance staff assesses the nominees based on three main criteria
– expertise, client service, leadership. 


What makes a good nomination? 

The most successful nominations are the ones that provide a good narrative
combined with data to support the assertions in the narrative, for example,
increased sales by xx%, conceived and launched a new product, reduced total cost
of risk by xx% etc. Of the three references that we require, the strongest
nominations have at least one reference from a person outside of their own
company, for example, a client of a nominee. 


How many people can I nominate? 

As many as you'd like. There is no limit. 


What if the nominee changes employers? 

As long as the nominee is still employed in the risk management and
property/casualty sector on June 1, they qualify. 


Do the people supplying references have to submit written testimonials? 

No. We will gladly accept written testimonials as part of the nomination;
however, we only require the name, telephone number and email of the references
be included in the nomination. The judges will contact references of those
candidates who have reached the final stages. 


Does the nominee need to know that they have been nominated? 

No, but most are aware they have been nominated. 


I want to nominate someone, but can I remain anonymous? 

No, we need to know who you are. We will not share your information with third
parties. 

Will more than one nominee from the same company be accepted? 

While you can nominate multiple people from one company, honorees are limited to
one per company per region. With four geographic regions, one company may have a
maximum of four winners. 


Do I have to select a region if the nominee has nationwide responsibilities? 

Yes. Select either the region where the nominee lives, where their main office
base is located or where their main responsibilities lie.  


What is required of those who are selected? 

Candidates who are selected must make themselves available for a phone interview
with a reporter. They also will need to provide a high-resolution headshot.  


Will I be informed if the candidate I nominate is not selected? 

Due to the volume of nominations we receive for our awards programs, we do not
contact unsuccessful applicants. However, the full list of honorees will be
available at BusinessInsurance.com in March. 

NOMINATION FORM

Please complete and submit the nomination form by February 13. If you have any
questions, please contact Gavin Souter, gsouter@businessinsurance.com
 

 * Nominee First Name :
 * Nominee Last Name :
 * Email :
 * Job Title :
 * Company :
 * Age on June 1, 2023 :
 * Years in current job sector:
 * Years in current position :
 * Principal professional responsibilities :
 * Firm's website :
 * LinkedIn profile (if available) :
 * Primary work address :
 * Region (please specify Northeast, Midwest, South or West. “United States” or
   “Nationwide” is NOT acceptable.):

 

Overview. Write a brief essay (limit 3,500 characters/~500 words) in the space
below that tells the judges about the nominee, please be specific as to
accomplishments.

 

Client service. Describe the nominee’s client service skills – internal or
external clients (limit 3,500 characters/~500 words).

 

Expertise. Describe the nominee’s expertise in his/her field of operations,
including professional accreditations, educational accomplishments, details of
any products of services developed (limit 3,500 characters/~500 words).

 

Leadership. Describe the nominee’s leadership qualities and achievements,
including career history and managerial experience (limit 3,500 characters/~500
words).

 

Recommendations. Provide three (3) recommendations from clients, managers and/or
co-workers. Recommendations may be either a brief written letter or contact
information so judges may contact references of those candidates who have
reached the final stages.

 

RECOMMENDATION 1

 * Name:
 * Email:
 * Phone:
 * Title:
 * Company:
 * Recommendation Letter Attachment : Remove

 

RECOMMENDATION 2

 * Name:
 * Email:
 * Phone:
 * Title:
 * Company:
 * Recommendation Letter Attachment : Remove

 

RECOMMENDATION 3

 * Name:
 * Email:
 * Phone:
 * Title:
 * Company:
 * Recommendation Letter Attachment : Remove

 


PERSON COMPLETING THIS NOMINATION:

 * First Name :
 * Last Name :
 * Email :
 * Phone :
 * Title :
 * Company :

 



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